In this article,we comment on the paper by Kakinuma et al published recently.We focus specifically on the diagnosis of uterine pseudoaneurysm,but we also review other uterine vascular anomalies that may be the cause o...In this article,we comment on the paper by Kakinuma et al published recently.We focus specifically on the diagnosis of uterine pseudoaneurysm,but we also review other uterine vascular anomalies that may be the cause of life-threating hemorrhage and the different causes of uterine pseudoaneurysms.Uterine artery pseudoaneurysm is a complication of both surgical gynecological and nontraumatic procedures.Massive hemorrhage is the consequence of the rupture of the pseudoaneurysm.Uterine artery pseudoaneurysm can develop after obstetric or gynecological procedures,being the most frequent after cesarean or vaginal deliveries,curettage and even during pregnancy.However,there are several cases described unrelated to pregnancy,such as after conization,hysteroscopic surgery or laparoscopic myomectomy.Hemorrhage is the clinical manifestation and it can be life-threatening so suspicion of this vascular lesion is essential for early diagnosis and treatment.However,there are other uterine vascular anomalies that may be the cause of severe hemorrhage,which must be taken into account in the differential diagnosis.Computed tomography angiography and embolization is supposed to be the first therapeutic option in most of them.展开更多
This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be consid...This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.展开更多
BACKGROUND Uterine injury can cause uterine scarring,leading to a series of complications that threaten women’s health.Uterine healing is a complex process,and there are currently no effective treatments.Although our...BACKGROUND Uterine injury can cause uterine scarring,leading to a series of complications that threaten women’s health.Uterine healing is a complex process,and there are currently no effective treatments.Although our previous studies have shown that bone marrow mesenchymal stem cells(BMSCs)promote uterine damage repair,the underlying mechanisms remain unclear.However,exploring the specific regulatory roles of BMSCs in uterine injury treatment is crucial for further understanding their functions and enhancing therapeutic efficacy.AIM To investigate the underlying mechanism by which BMSCs promote the process of uterine healing.METHODS In in vivo experiments,we established a model of full-thickness uterine injury and injected BMSCs into the uterine wound.Transcriptome sequencing was per-formed to determine the enrichment of differentially expressed genes at the wound site.In in vitro experiments,we isolated rat uterine smooth muscle cells(USMCs)and cocultured them with BMSCs to observe the interaction between BMSCs and USMCs in the microenvironment.RESULTS We found that the differentially expressed genes were mainly related to cell growth,tissue repair,and angiogenesis,while the phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)pathway was highly enriched.Quantitative reverse-transcription polymerase chain reaction was used to validate differentially expressed genes,and the results demonstrated that BMSCs can upregulate genes related to regeneration and downregulate genes related to inflammation.Coculturing BMSCs promoted the migration and proliferation of USMCs,and the USMC microenvironment promoted the myogenic differentiation of BMSCs.Finally,we validated the PI3K/AKT pathway in tissues and cells and showed that BMSCs activate the PI3K/AKT pathway to promote the regeneration of uterine smooth muscle both in vivo and in vitro.CONCLUSION BMSCs upregulated uterine wound regeneration and anti-inflammatory factors and enhanced uterine smooth muscle proliferation through the PI3K/AKT pathway both in vivo and in vitro.展开更多
BACKGROUND The classification of uterine sarcomas is based on distinctive morphological and immunophenotypic characteristics,increasingly supported by molecular genetic diagnostics.Data on neurotrophic tyrosine recept...BACKGROUND The classification of uterine sarcomas is based on distinctive morphological and immunophenotypic characteristics,increasingly supported by molecular genetic diagnostics.Data on neurotrophic tyrosine receptor kinase(NTRK)gene fusionpositive uterine sarcoma,potentially aggressive and morphologically similar to fibrosarcoma,are limited due to its recent recognition.Pan-TRK immunohistochemistry(IHC)analysis serves as an effective screening tool with high sensitivity and specificity for NTRK-fusion malignancies.CASE SUMMARY We report a case of a malignant mesenchymal tumor originating from the uterine cervix,which was pan-TRK IHC-positive but lacked NTRK gene fusions,accompanied by a brief literature review.A 55-year-old woman presented to the emergency department with abdominal pain and distension,exhibiting significant ascites and multiple solid pelvic masses.Pelvic examination revealed a tumor encompassing the uterine cervix,extending to the vagina and uterine corpus.A punch biopsy of the cervix indicated NTRK sarcoma with positive immunochemical pan-TRK stain.However,subsequent next generation sequencing revealed no NTRK gene fusion,leading to a diagnosis of poorly differentiated,advanced-stage sarcoma.CONCLUSION The clinical significance of NTRK gene fusion lies in potential treatment with TRK inhibitors for positive sarcomas.Identifying such rare tumors is crucial due to the potential applicability of tropomyosin receptor kinase inhibitor treatment.展开更多
BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which...BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which may mimic malignancy.Here,we describe a case of adenomyosis-associated uterine rupture(secondary to hemorrhagic necrosis)and concurrent pulmonary endometriosis in a 16-year-old girl initially suspected of having advanced uterine cancer.CASE SUMMARY A 16-year-old girl presented with acute abdominal pain and oliguria.Imaging studies revealed a 15-cm ruptured uterine mass accompanied by hemoperitoneum and multiple pulmonary nodules suggestive of metastatic disease.Laboratory tests demonstrated severe anemia and markedly elevated tumor markers[cancer antigen(CA)-125:1063 U/mL;CA-19-9:1347 U/mL].Emergency laparotomy revealed adenomyosis-associated uterine rupture secondary to hemorrhagic necrosis,with no macroscopic abnormalities in other organs.A total abdominal hysterectomy was performed.Histopathological analysis confirmed uterine adenomyosis with hemorrhagic necrosis.Subsequent thoracoscopic wedge resections of the pulmonary lesions demonstrated histologically confirmed endometriosis.The patient has remained disease-free under treatment with oral dienogest.CONCLUSION This case of an adolescent patient highlights how benign gynecological conditions can mimic malignancy,necessitating broad differential diagnoses despite alarming presentations.展开更多
BACKGROUND Pre-eclampsia is a significant challenge in obstetric care and adversely affects the feto-maternal outcomes,causing significant perinatal morbidity and mortality.Early detection of women at higher risk of d...BACKGROUND Pre-eclampsia is a significant challenge in obstetric care and adversely affects the feto-maternal outcomes,causing significant perinatal morbidity and mortality.Early detection of women at higher risk of developing pre-eclampsia in the first trimester provides a vital opportunity to initiate timely prophylactic therapies.First-trimester uterine artery Doppler is gaining prominence as a promising tool in early risk stratification.AIM To assess the role of uterine artery Doppler in screening for pre-eclampsia at 11-14 weeks of gestation.METHODS Pregnant women attending routine antenatal care between 11 weeks and 14 weeks of gestation and undergoing first-trimester nuchal translucency screening were offered enrolment in the study.After calculating gestational age from the last menstrual period or fetal biometry(crown-rump length),Doppler ultrasound of bilateral uterine arteries was performed,and relevant Doppler parameters were recorded.Patients were followed until delivery for development of preeclampsia.RESULTS Out of a total of 342 participants,42 women(12.28%)developed preeclampsia,while the remaining 300 women(87.71%)had a normal pregnancy without preeclampsia.The mean uterine artery pulsatility index was significantly elevated in the pre-eclampsia group(1.9455±0.36)compared to the normal group(1.474±0.52)(P<0.001).Using a pulsatility index threshold of 1.622,the receiver operating characteristic curve analysis demonstrated a sensitivity of 75%(95%confidence internal:0.66-0.82),specificity of 86%(95%confidence internal:0.78-0.91),positive predictive value of 84.27%,and negative predictive value of 77.48%with a diagnostic accuracy of 80.5%.The area under the curve was 0.896,indicating good diagnostic performance.Uterine artery notching was observed in 88%of the pre-eclampsia group compared to 16%in the control group,a difference that was statistically significant(P<0.001).CONCLUSION Uterine artery Doppler in the first trimester at 11-14 weeks of gestation showed a good diagnostic value for forecasting the development of pre-eclampsia and holds promise as a valuable tool for early risk stratification.展开更多
BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgicall...BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgically.Despite the risks of massive intraoperative bleeding and acute and long-term complications,uterine artery embolization is often selected.Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.CASE SUMMARY We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion.We performed laparoscopic resection with hysteroscopy.Since the lesion had abundant blood flow,we temporarily blocked the bilateral uterine arteries to prevent massive intraop-erative bleeding.The surgical process went smoothly.The postoperative course was uneventful.CONCLUSION Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.展开更多
Objective:To investigate the delivery modes of women with repeat pregnancies involving uterine scars and their effects on both mothers and neonates.Methods:A study was conducted on 100 patients treated at Shenzhen Mat...Objective:To investigate the delivery modes of women with repeat pregnancies involving uterine scars and their effects on both mothers and neonates.Methods:A study was conducted on 100 patients treated at Shenzhen Maternity and Child Healthcare Hospital from July 2023 to July 2024.The participants were divided into a control group and an observation group,with 50 cases in each.The division was based on the indications for prior cesarean section,cervical maturity,postpartum complications,and thickness of the cesarean scar.The control group underwent cesarean delivery,while the observation group experienced vaginal delivery.The two groups were compared in terms of intrapartum blood loss,postpartum blood loss within 2 hours,length of hospital stay,Apgar scores at 1-minute post-birth,and incidences of neonatal fever and jaundice.Results:The observation group had significantly lower intrapartum blood loss,postpartum blood loss within 2 hours,and shorter hospital stays compared to the control group(P<0.05).Additionally,the Apgar scores at 1 minute post-birth were significantly higher in the observation group(P<0.05).The incidence of neonatal fever and jaundice was significantly lower in the observation group(P<0.05).These differences were statistically significant.Conclusion:Vaginal delivery has high clinical value for women with repeat pregnancies involving uterine scars.It reduces maternal intrapartum and postpartum blood loss,shortens hospital stays,improves neonatal Apgar scores,and decreases the incidences of neonatal fever and jaundice.This method is worthy of clinical application and promotion.展开更多
Background Uterine aging is a key factor contributing to the deterioration of egg quality and reproductive performance in laying hens.Despite its importance,the molecular mechanisms underlying uterine aging remain poo...Background Uterine aging is a key factor contributing to the deterioration of egg quality and reproductive performance in laying hens.Despite its importance,the molecular mechanisms underlying uterine aging remain poorly defined.This study aimed to characterize gene expression and regulatory changes associated with uterine aging in hens at different life stages.Results Transcriptomic Analysis of uterine tissue from hens aged 350,500,And 700 d revealed dynamic changes in gene expression patterns during aging.A significant upregulation of genes involved in cellular senescence was observed,including increased expression of the p53 signaling pathway And markers associated with inflammation And cell cycle arrest.The most notable changes occurred between 350 And 500 d of age,suggesting this as a critical window for the onset of uterine aging.MicroRNA sequencing identified miR-210a-5p as significantly reduced with age.Target prediction and experimental validation showed that miR-210a-5p directly suppresses the expression of RASL11B,a Ras-like small GTPase that activates the MAPK signaling pathway.In primary uterine epithelial cells,reduced miR-210a-5p levels led to elevated RASL11B expression,increased activation of B-Raf,MEK,and ERK proteins,and enhanced expression of aging-related genes and inflammatory factors.In contrast,overexpression of miR-210a-5p or inhibition of the MAPK pathway delayed senescence and reduced inflammatory signaling.RASL11B overexpression was sufficient to induce aging phenotypes,confirming its central role in promoting uterine cellular aging.Conclusions This study identifies a novel regulatory pathway in which miR-210a-5p modulates uterine aging through the RASL11B-MAPK signaling cascade.The findings provide mechanistic insight into age-related reproductive decline in hens and suggest that targeting this pathway may offer new strategies for maintaining uterine function and extending reproductive lifespan in poultry.展开更多
OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar d...OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.展开更多
Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high in...BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high invasiveness and poor prognosis,with limited global reports on this condition.CASE SUMMARY A 58-year-old Chinese woman presented with painless vaginal bleeding after sexual intercourse,which appeared as droplets.HPV testing and histopathological analysis confirmed the diagnosis of HPV-associated primary serous carcinoma of the USCC.The patient underwent radical hysterectomy and was diagnosed with primary serous carcinoma of the uterine cervix,stage III C2(FIGO 2018).A multimodal treatment approach,including surgery,radiotherapy,and chemotherapy,was administered.After additional concurrent chemoradiotherapy and three cycles of chemotherapy,the patient showed no evidence of disease progression and achieved long-term survival for 53 months.CONCLUSION USCC is a rare and aggressive malignancy.Upon diagnosis,multimodal treatment strategies,including surgery,radiotherapy,and chemotherapy,can effectively prolong patient survival and improve prognosis.展开更多
[Objectives]To investigate the effect of extract A from Blumea megacephala(Randeria)Chang et Tseng on the hemostasis of postpartum uterine hemorrhage in early pregnancy rats.[Methods]12 mg/kg of mifepristone and 120μ...[Objectives]To investigate the effect of extract A from Blumea megacephala(Randeria)Chang et Tseng on the hemostasis of postpartum uterine hemorrhage in early pregnancy rats.[Methods]12 mg/kg of mifepristone and 120μg/kg of misoprostol were used to establish the uterine bleeding model of early pregnancy rats,and the effects of the drugs on the amount of uterine bleeding,the contents of angiotensin II(Ang-II)and prostaglandin E 2(PGE 2)in serum,the four factors of coagulation,platelet adhesion,platelet aggregation and platelet number were investigated.[Results]Extract A can shorten prothrombin time(PT)and activated partial thromboplastin time(APTT)in rats.It can reduce the amount of uterine bleeding in the model,reduce the contents of PGE 2 and Ang-II,reduce APTT and PT,increase the content of fibrinogen FIB,enhance platelet adhesion,enhance platelet aggregation and increase the number of platelets.[Conclusions]Extract A has obvious hemostatic effect on uterine bleeding model of early pregnancy rats.It may play a hemostatic role by affecting vasoconstriction-dilation,coagulation factors in the blood s internal and external coagulation system,platelet adhesion and aggregation,increasing FIB content,increasing platelet number,affecting uterine bleeding,etc.,showing the characteristics of multiple pathways and multiple targets.展开更多
Objective To investigate the diagnostic methods of pubertal uterine malformations in nongestational stage Method Hysteroscopy combined with transabdominal ultrasonography was used to diagnose and differentiate rudi...Objective To investigate the diagnostic methods of pubertal uterine malformations in nongestational stage Method Hysteroscopy combined with transabdominal ultrasonography was used to diagnose and differentiate rudimentary uterine horn and blind uterine horn in puberty. Results The accuracy of the two diagnostic methods performed simultaneously was valuable in the diagnosis of pubertal unicornuate uterus with blind uterine horn in 3 cases and rudimentary uterine horn in 2 cases. Conclusion Hysteroscopy combined with transabdominal ultrasonography was reliable in diag- nosing uterine malformations and especially effective in treating maiden with rudimentary horn and blind horn of uterus.展开更多
Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinum...Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinuma et al,which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman.Utilizing advanced imaging techniques such as ultrasound and computed tomography(CT),the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition.The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases.This article aims to expand on the study’s findings,discuss the clinical implications,and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery.展开更多
BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion ...BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion include expulsion,displacement,and uterine perforation.Ultrasonic identification of copper intrauterine devices(IUDs)is possible due to echogenicity from the copper coils.However,the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic images.Both barium sulfate and copper are radiopaque and clearly identifiable on X-ray.Thus,X-ray imaging is required to locate LNG-IUSs.CASE SUMMARY A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another hospital.Three LNG-IUS insertions had apparently been followed by spontaneous expulsion,although objective confirmation using imaging was not performed.The patient was referred to our institution for surgery.At the first visit,there appeared to be no device in the uterus,and none was observed on transvaginal ultrasound.However,two LNGIUSs were observed in the pelvis on abdominal plain X-rays prior to surgery.Hysteroscopic myomectomy was performed,and the two LNG-IUSs were found to have perforated the myometrium.The devices were safely removed during surgery,and the submucosal myomas were also removed.The perforated section of the myometrium was minimal+ADs-therefore,a repair operation was not required.CONCLUSION Plain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine cavity.Therefore,it is important to confirm a device’s location,regardless of whether spontaneous expulsion is suspected,prior to inserting another device.展开更多
Purpose: To evaluate the accuracy of sonographic measurements of the lower uterine segment (LUS) thickness at term in predicting uterine scar defects in women with previous Cesarean delivery (CD). Methods: Eighty-nine...Purpose: To evaluate the accuracy of sonographic measurements of the lower uterine segment (LUS) thickness at term in predicting uterine scar defects in women with previous Cesarean delivery (CD). Methods: Eighty-nine pregnant women who underwent CD between 37 and 41 weeks of gestation from 2013 to 2015 were enrolled in this study and divided into two groups. Group A consisted of women with previous CD, and Group B consisted of women with previous vaginal deliveries. We performed an ultrasound evaluation of the myometrial and full thickness of LUS (mLUS and fLUS) transvaginally before a CD and evaluated the appearance of LUS during surgery, which was defined as follows: grade I, well-developed;grade II, thin without visible content;grade III, translucent with visible content;and grade IV, either dehiscence or rupture. Results: The median mLUS and fLUS were 1.50 and 4.07 mm in the group A, and 2.75 and 5.37 mm in the group B. We observed significant differences in the median mLUS and fLUS between grades I/II (2.07 and 4.37 mm) and grades III/IV (0.67 and 2.52 mm). Both mLUS and fLUS were predictive factors for grades III/IV and cutoff values were 0.97 mm of mLUS and 3.13 mm of fLUS, having a sensitivity of 87.5% and 75.0%, and a specificity of 87.7% and 91.4% in mLUS and fLUS measurement, respectively. Conclusion: Sonographic measurements of LUS at term may be a feasible and reliable method to predict uterine rupture or uterine dehiscence in women with prior CD.展开更多
The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea(PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on ut...The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea(PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on uterine artery blood velocity of Ge-Gen Decoction(GGD), a well-known Chinese herbal formula. In female ICR mice, uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment, and the uterine artery blood velocity was detected by Doppler ultrasound. Histopathological examination of the uterine tissue samples were performed by H&E staining. Ex vivo studies demonstrated that oxytocin, posterior pituitary, or acetylcholine induced contractions in isolated mouse uterus. GGD inhibited both spontaneous and stimulated contractions. In vivo study demonstrated that GGD significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 87%. Further study demonstrated that GGD normalized oxytocin-induced abnormalities of prostaglandins F_2 alpha(PGF_(2α)) and Ca^(2+) in mice. In addition, injection of oxytocin induced a decrease in uterine artery blood flow velocity. Pretreatment with GGD reversed the oxytocin response on blood flow velocity. Histopathological examination showed pretreatment with GGD alleviated inflammation and edema in the uterus when compared with the model group. Both ex vivo and in vivo results indicated that GGD possessed a significant spasmolytic effect on uterine tetanic contraction as well as improvement on uterine artery blood velocity which may involve PGF_(2α) and Ca^(2+) signaling, suggesting that GGD may have a clinic potential in PD therapy.展开更多
BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that t...BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.展开更多
In searching for differentially expressed genes in human uterine leiomyomas (ULs), suppression sub-tractive hybridization was used to construct an UL up-regulated library, which turned out to represent 88genes. After ...In searching for differentially expressed genes in human uterine leiomyomas (ULs), suppression sub-tractive hybridization was used to construct an UL up-regulated library, which turned out to represent 88genes. After two rounds of screening by reverse Northern analysis, twenty genes were proved to be up-regulated, including seventeen known genes and three genes with unknown function. All these genes werefirstly associated with UL. Three genes with notable difference were selected for Northern confirmationOur results proved the authenticity of the twenty genes. One gene named Phospholipase A2 (PLA2) showedup-regulation in 4/6 of the patients and investigation of tissue distribution indicated that it had obviousexpression in prostate, testis, liver, heart and skeletal muscle.展开更多
文摘In this article,we comment on the paper by Kakinuma et al published recently.We focus specifically on the diagnosis of uterine pseudoaneurysm,but we also review other uterine vascular anomalies that may be the cause of life-threating hemorrhage and the different causes of uterine pseudoaneurysms.Uterine artery pseudoaneurysm is a complication of both surgical gynecological and nontraumatic procedures.Massive hemorrhage is the consequence of the rupture of the pseudoaneurysm.Uterine artery pseudoaneurysm can develop after obstetric or gynecological procedures,being the most frequent after cesarean or vaginal deliveries,curettage and even during pregnancy.However,there are several cases described unrelated to pregnancy,such as after conization,hysteroscopic surgery or laparoscopic myomectomy.Hemorrhage is the clinical manifestation and it can be life-threatening so suspicion of this vascular lesion is essential for early diagnosis and treatment.However,there are other uterine vascular anomalies that may be the cause of severe hemorrhage,which must be taken into account in the differential diagnosis.Computed tomography angiography and embolization is supposed to be the first therapeutic option in most of them.
文摘This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.
基金support from the“111 program”of Ministry of Education of China and State Administration of Foreign Experts Affairs of China.
文摘BACKGROUND Uterine injury can cause uterine scarring,leading to a series of complications that threaten women’s health.Uterine healing is a complex process,and there are currently no effective treatments.Although our previous studies have shown that bone marrow mesenchymal stem cells(BMSCs)promote uterine damage repair,the underlying mechanisms remain unclear.However,exploring the specific regulatory roles of BMSCs in uterine injury treatment is crucial for further understanding their functions and enhancing therapeutic efficacy.AIM To investigate the underlying mechanism by which BMSCs promote the process of uterine healing.METHODS In in vivo experiments,we established a model of full-thickness uterine injury and injected BMSCs into the uterine wound.Transcriptome sequencing was per-formed to determine the enrichment of differentially expressed genes at the wound site.In in vitro experiments,we isolated rat uterine smooth muscle cells(USMCs)and cocultured them with BMSCs to observe the interaction between BMSCs and USMCs in the microenvironment.RESULTS We found that the differentially expressed genes were mainly related to cell growth,tissue repair,and angiogenesis,while the phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)pathway was highly enriched.Quantitative reverse-transcription polymerase chain reaction was used to validate differentially expressed genes,and the results demonstrated that BMSCs can upregulate genes related to regeneration and downregulate genes related to inflammation.Coculturing BMSCs promoted the migration and proliferation of USMCs,and the USMC microenvironment promoted the myogenic differentiation of BMSCs.Finally,we validated the PI3K/AKT pathway in tissues and cells and showed that BMSCs activate the PI3K/AKT pathway to promote the regeneration of uterine smooth muscle both in vivo and in vitro.CONCLUSION BMSCs upregulated uterine wound regeneration and anti-inflammatory factors and enhanced uterine smooth muscle proliferation through the PI3K/AKT pathway both in vivo and in vitro.
基金Supported by Grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute,funded by the Ministry of Health&Welfare,Republic of Korea,No.RS-2022-KH129889.
文摘BACKGROUND The classification of uterine sarcomas is based on distinctive morphological and immunophenotypic characteristics,increasingly supported by molecular genetic diagnostics.Data on neurotrophic tyrosine receptor kinase(NTRK)gene fusionpositive uterine sarcoma,potentially aggressive and morphologically similar to fibrosarcoma,are limited due to its recent recognition.Pan-TRK immunohistochemistry(IHC)analysis serves as an effective screening tool with high sensitivity and specificity for NTRK-fusion malignancies.CASE SUMMARY We report a case of a malignant mesenchymal tumor originating from the uterine cervix,which was pan-TRK IHC-positive but lacked NTRK gene fusions,accompanied by a brief literature review.A 55-year-old woman presented to the emergency department with abdominal pain and distension,exhibiting significant ascites and multiple solid pelvic masses.Pelvic examination revealed a tumor encompassing the uterine cervix,extending to the vagina and uterine corpus.A punch biopsy of the cervix indicated NTRK sarcoma with positive immunochemical pan-TRK stain.However,subsequent next generation sequencing revealed no NTRK gene fusion,leading to a diagnosis of poorly differentiated,advanced-stage sarcoma.CONCLUSION The clinical significance of NTRK gene fusion lies in potential treatment with TRK inhibitors for positive sarcomas.Identifying such rare tumors is crucial due to the potential applicability of tropomyosin receptor kinase inhibitor treatment.
文摘BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which may mimic malignancy.Here,we describe a case of adenomyosis-associated uterine rupture(secondary to hemorrhagic necrosis)and concurrent pulmonary endometriosis in a 16-year-old girl initially suspected of having advanced uterine cancer.CASE SUMMARY A 16-year-old girl presented with acute abdominal pain and oliguria.Imaging studies revealed a 15-cm ruptured uterine mass accompanied by hemoperitoneum and multiple pulmonary nodules suggestive of metastatic disease.Laboratory tests demonstrated severe anemia and markedly elevated tumor markers[cancer antigen(CA)-125:1063 U/mL;CA-19-9:1347 U/mL].Emergency laparotomy revealed adenomyosis-associated uterine rupture secondary to hemorrhagic necrosis,with no macroscopic abnormalities in other organs.A total abdominal hysterectomy was performed.Histopathological analysis confirmed uterine adenomyosis with hemorrhagic necrosis.Subsequent thoracoscopic wedge resections of the pulmonary lesions demonstrated histologically confirmed endometriosis.The patient has remained disease-free under treatment with oral dienogest.CONCLUSION This case of an adolescent patient highlights how benign gynecological conditions can mimic malignancy,necessitating broad differential diagnoses despite alarming presentations.
文摘BACKGROUND Pre-eclampsia is a significant challenge in obstetric care and adversely affects the feto-maternal outcomes,causing significant perinatal morbidity and mortality.Early detection of women at higher risk of developing pre-eclampsia in the first trimester provides a vital opportunity to initiate timely prophylactic therapies.First-trimester uterine artery Doppler is gaining prominence as a promising tool in early risk stratification.AIM To assess the role of uterine artery Doppler in screening for pre-eclampsia at 11-14 weeks of gestation.METHODS Pregnant women attending routine antenatal care between 11 weeks and 14 weeks of gestation and undergoing first-trimester nuchal translucency screening were offered enrolment in the study.After calculating gestational age from the last menstrual period or fetal biometry(crown-rump length),Doppler ultrasound of bilateral uterine arteries was performed,and relevant Doppler parameters were recorded.Patients were followed until delivery for development of preeclampsia.RESULTS Out of a total of 342 participants,42 women(12.28%)developed preeclampsia,while the remaining 300 women(87.71%)had a normal pregnancy without preeclampsia.The mean uterine artery pulsatility index was significantly elevated in the pre-eclampsia group(1.9455±0.36)compared to the normal group(1.474±0.52)(P<0.001).Using a pulsatility index threshold of 1.622,the receiver operating characteristic curve analysis demonstrated a sensitivity of 75%(95%confidence internal:0.66-0.82),specificity of 86%(95%confidence internal:0.78-0.91),positive predictive value of 84.27%,and negative predictive value of 77.48%with a diagnostic accuracy of 80.5%.The area under the curve was 0.896,indicating good diagnostic performance.Uterine artery notching was observed in 88%of the pre-eclampsia group compared to 16%in the control group,a difference that was statistically significant(P<0.001).CONCLUSION Uterine artery Doppler in the first trimester at 11-14 weeks of gestation showed a good diagnostic value for forecasting the development of pre-eclampsia and holds promise as a valuable tool for early risk stratification.
文摘BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgically.Despite the risks of massive intraoperative bleeding and acute and long-term complications,uterine artery embolization is often selected.Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.CASE SUMMARY We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion.We performed laparoscopic resection with hysteroscopy.Since the lesion had abundant blood flow,we temporarily blocked the bilateral uterine arteries to prevent massive intraop-erative bleeding.The surgical process went smoothly.The postoperative course was uneventful.CONCLUSION Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.
文摘Objective:To investigate the delivery modes of women with repeat pregnancies involving uterine scars and their effects on both mothers and neonates.Methods:A study was conducted on 100 patients treated at Shenzhen Maternity and Child Healthcare Hospital from July 2023 to July 2024.The participants were divided into a control group and an observation group,with 50 cases in each.The division was based on the indications for prior cesarean section,cervical maturity,postpartum complications,and thickness of the cesarean scar.The control group underwent cesarean delivery,while the observation group experienced vaginal delivery.The two groups were compared in terms of intrapartum blood loss,postpartum blood loss within 2 hours,length of hospital stay,Apgar scores at 1-minute post-birth,and incidences of neonatal fever and jaundice.Results:The observation group had significantly lower intrapartum blood loss,postpartum blood loss within 2 hours,and shorter hospital stays compared to the control group(P<0.05).Additionally,the Apgar scores at 1 minute post-birth were significantly higher in the observation group(P<0.05).The incidence of neonatal fever and jaundice was significantly lower in the observation group(P<0.05).These differences were statistically significant.Conclusion:Vaginal delivery has high clinical value for women with repeat pregnancies involving uterine scars.It reduces maternal intrapartum and postpartum blood loss,shortens hospital stays,improves neonatal Apgar scores,and decreases the incidences of neonatal fever and jaundice.This method is worthy of clinical application and promotion.
基金funded by the National Key Research and Development Program of China,grant number 2021YFD1300600Sichuan Science and Technology Program(2024YFNH0025,2022YFYZ0005,2021YFYZ0031)China Agriculture Research System of MOF and MARA(CARS-40).
文摘Background Uterine aging is a key factor contributing to the deterioration of egg quality and reproductive performance in laying hens.Despite its importance,the molecular mechanisms underlying uterine aging remain poorly defined.This study aimed to characterize gene expression and regulatory changes associated with uterine aging in hens at different life stages.Results Transcriptomic Analysis of uterine tissue from hens aged 350,500,And 700 d revealed dynamic changes in gene expression patterns during aging.A significant upregulation of genes involved in cellular senescence was observed,including increased expression of the p53 signaling pathway And markers associated with inflammation And cell cycle arrest.The most notable changes occurred between 350 And 500 d of age,suggesting this as a critical window for the onset of uterine aging.MicroRNA sequencing identified miR-210a-5p as significantly reduced with age.Target prediction and experimental validation showed that miR-210a-5p directly suppresses the expression of RASL11B,a Ras-like small GTPase that activates the MAPK signaling pathway.In primary uterine epithelial cells,reduced miR-210a-5p levels led to elevated RASL11B expression,increased activation of B-Raf,MEK,and ERK proteins,and enhanced expression of aging-related genes and inflammatory factors.In contrast,overexpression of miR-210a-5p or inhibition of the MAPK pathway delayed senescence and reduced inflammatory signaling.RASL11B overexpression was sufficient to induce aging phenotypes,confirming its central role in promoting uterine cellular aging.Conclusions This study identifies a novel regulatory pathway in which miR-210a-5p modulates uterine aging through the RASL11B-MAPK signaling cascade.The findings provide mechanistic insight into age-related reproductive decline in hens and suggest that targeting this pathway may offer new strategies for maintaining uterine function and extending reproductive lifespan in poultry.
文摘OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
基金Supported by the Sichuan Science and Technology Program,No.2022NSFSC0797.
文摘BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high invasiveness and poor prognosis,with limited global reports on this condition.CASE SUMMARY A 58-year-old Chinese woman presented with painless vaginal bleeding after sexual intercourse,which appeared as droplets.HPV testing and histopathological analysis confirmed the diagnosis of HPV-associated primary serous carcinoma of the USCC.The patient underwent radical hysterectomy and was diagnosed with primary serous carcinoma of the uterine cervix,stage III C2(FIGO 2018).A multimodal treatment approach,including surgery,radiotherapy,and chemotherapy,was administered.After additional concurrent chemoradiotherapy and three cycles of chemotherapy,the patient showed no evidence of disease progression and achieved long-term survival for 53 months.CONCLUSION USCC is a rare and aggressive malignancy.Upon diagnosis,multimodal treatment strategies,including surgery,radiotherapy,and chemotherapy,can effectively prolong patient survival and improve prognosis.
基金Supported by the University-level Project of Guangxi University of Chinese Medicine(2021ZD005).
文摘[Objectives]To investigate the effect of extract A from Blumea megacephala(Randeria)Chang et Tseng on the hemostasis of postpartum uterine hemorrhage in early pregnancy rats.[Methods]12 mg/kg of mifepristone and 120μg/kg of misoprostol were used to establish the uterine bleeding model of early pregnancy rats,and the effects of the drugs on the amount of uterine bleeding,the contents of angiotensin II(Ang-II)and prostaglandin E 2(PGE 2)in serum,the four factors of coagulation,platelet adhesion,platelet aggregation and platelet number were investigated.[Results]Extract A can shorten prothrombin time(PT)and activated partial thromboplastin time(APTT)in rats.It can reduce the amount of uterine bleeding in the model,reduce the contents of PGE 2 and Ang-II,reduce APTT and PT,increase the content of fibrinogen FIB,enhance platelet adhesion,enhance platelet aggregation and increase the number of platelets.[Conclusions]Extract A has obvious hemostatic effect on uterine bleeding model of early pregnancy rats.It may play a hemostatic role by affecting vasoconstriction-dilation,coagulation factors in the blood s internal and external coagulation system,platelet adhesion and aggregation,increasing FIB content,increasing platelet number,affecting uterine bleeding,etc.,showing the characteristics of multiple pathways and multiple targets.
文摘Objective To investigate the diagnostic methods of pubertal uterine malformations in nongestational stage Method Hysteroscopy combined with transabdominal ultrasonography was used to diagnose and differentiate rudimentary uterine horn and blind uterine horn in puberty. Results The accuracy of the two diagnostic methods performed simultaneously was valuable in the diagnosis of pubertal unicornuate uterus with blind uterine horn in 3 cases and rudimentary uterine horn in 2 cases. Conclusion Hysteroscopy combined with transabdominal ultrasonography was reliable in diag- nosing uterine malformations and especially effective in treating maiden with rudimentary horn and blind horn of uterus.
基金Supported by Basic Science Research Program Through the National Research Foundation of Korea(NRF)Funded by the Ministry of Education,No.NRF-RS-2023-00237287 and No.NRF-2021S1A5A8062526Local Government-University Cooperation-Based Regional Innovation Projects,No.2021RIS-003.
文摘Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinuma et al,which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman.Utilizing advanced imaging techniques such as ultrasound and computed tomography(CT),the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition.The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases.This article aims to expand on the study’s findings,discuss the clinical implications,and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery.
文摘BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion include expulsion,displacement,and uterine perforation.Ultrasonic identification of copper intrauterine devices(IUDs)is possible due to echogenicity from the copper coils.However,the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic images.Both barium sulfate and copper are radiopaque and clearly identifiable on X-ray.Thus,X-ray imaging is required to locate LNG-IUSs.CASE SUMMARY A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another hospital.Three LNG-IUS insertions had apparently been followed by spontaneous expulsion,although objective confirmation using imaging was not performed.The patient was referred to our institution for surgery.At the first visit,there appeared to be no device in the uterus,and none was observed on transvaginal ultrasound.However,two LNGIUSs were observed in the pelvis on abdominal plain X-rays prior to surgery.Hysteroscopic myomectomy was performed,and the two LNG-IUSs were found to have perforated the myometrium.The devices were safely removed during surgery,and the submucosal myomas were also removed.The perforated section of the myometrium was minimal+ADs-therefore,a repair operation was not required.CONCLUSION Plain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine cavity.Therefore,it is important to confirm a device’s location,regardless of whether spontaneous expulsion is suspected,prior to inserting another device.
文摘Purpose: To evaluate the accuracy of sonographic measurements of the lower uterine segment (LUS) thickness at term in predicting uterine scar defects in women with previous Cesarean delivery (CD). Methods: Eighty-nine pregnant women who underwent CD between 37 and 41 weeks of gestation from 2013 to 2015 were enrolled in this study and divided into two groups. Group A consisted of women with previous CD, and Group B consisted of women with previous vaginal deliveries. We performed an ultrasound evaluation of the myometrial and full thickness of LUS (mLUS and fLUS) transvaginally before a CD and evaluated the appearance of LUS during surgery, which was defined as follows: grade I, well-developed;grade II, thin without visible content;grade III, translucent with visible content;and grade IV, either dehiscence or rupture. Results: The median mLUS and fLUS were 1.50 and 4.07 mm in the group A, and 2.75 and 5.37 mm in the group B. We observed significant differences in the median mLUS and fLUS between grades I/II (2.07 and 4.37 mm) and grades III/IV (0.67 and 2.52 mm). Both mLUS and fLUS were predictive factors for grades III/IV and cutoff values were 0.97 mm of mLUS and 3.13 mm of fLUS, having a sensitivity of 87.5% and 75.0%, and a specificity of 87.7% and 91.4% in mLUS and fLUS measurement, respectively. Conclusion: Sonographic measurements of LUS at term may be a feasible and reliable method to predict uterine rupture or uterine dehiscence in women with prior CD.
基金supported by a grant from Ministry of Education,the New Teachers’Fund for Ph.D Stations(Program No.20110096120011)2011’Program for Excellent Scientific and Technological Innovation Team of Jiangsu Higher Education
文摘The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea(PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on uterine artery blood velocity of Ge-Gen Decoction(GGD), a well-known Chinese herbal formula. In female ICR mice, uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment, and the uterine artery blood velocity was detected by Doppler ultrasound. Histopathological examination of the uterine tissue samples were performed by H&E staining. Ex vivo studies demonstrated that oxytocin, posterior pituitary, or acetylcholine induced contractions in isolated mouse uterus. GGD inhibited both spontaneous and stimulated contractions. In vivo study demonstrated that GGD significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 87%. Further study demonstrated that GGD normalized oxytocin-induced abnormalities of prostaglandins F_2 alpha(PGF_(2α)) and Ca^(2+) in mice. In addition, injection of oxytocin induced a decrease in uterine artery blood flow velocity. Pretreatment with GGD reversed the oxytocin response on blood flow velocity. Histopathological examination showed pretreatment with GGD alleviated inflammation and edema in the uterus when compared with the model group. Both ex vivo and in vivo results indicated that GGD possessed a significant spasmolytic effect on uterine tetanic contraction as well as improvement on uterine artery blood velocity which may involve PGF_(2α) and Ca^(2+) signaling, suggesting that GGD may have a clinic potential in PD therapy.
文摘BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.
基金This work was supported by Nationa1 NaturalScience Fundation of China No.39700148 and LifeScience Special fund of CAS supported by ChineseMinisery of Finance.
文摘In searching for differentially expressed genes in human uterine leiomyomas (ULs), suppression sub-tractive hybridization was used to construct an UL up-regulated library, which turned out to represent 88genes. After two rounds of screening by reverse Northern analysis, twenty genes were proved to be up-regulated, including seventeen known genes and three genes with unknown function. All these genes werefirstly associated with UL. Three genes with notable difference were selected for Northern confirmationOur results proved the authenticity of the twenty genes. One gene named Phospholipase A2 (PLA2) showedup-regulation in 4/6 of the patients and investigation of tissue distribution indicated that it had obviousexpression in prostate, testis, liver, heart and skeletal muscle.
