Objective To compare the effect of different ways of the closure of peritoneum and uterus in caesarean section Materials and Methods We searched for studies from the following databases: Pubmed, Cochrane Library, CKNI, and CSPD from Jan 2000 to Jan 2017. χ2 test was used to test the heterogeneity and it is considered there was heterogeneity if I2 >50%, under which circumstance we used the random-effect model rather than the fixed-effect model. Results Non-closure of both parietal and visceral peritoneum was associated with shorter operative time (mean difference [MD]=-5.61，95%CI：-8.14, -3.07，P<0.0001), without the impact on the additional analgesia given (Relative risk [RR]=0.95，95% confidence interval [CI]：0.70, 1.15， P=0.40), the days of hospitalization (MD=-0.05，95%CI：-0.14, 0.04，P=0.09), the risk of postoperative fever (RR=1.03，95%CI：0.73, 1.44，P=0.88), wound infection (RR=0.90，95%CI： 0.79, 1.04 ， P=0.15),endometritis (RR=1.06 ， 95%CI ： 0.74, 1.52 ， P=0.76) and adhesion formation(RR=1.44，95%CI：0.58, 3.61，P=0.43). Single-layer uterine closure was linked with a significant reduction of the residual myometrial thickness (RMT) (MD=-1.89，95%CI：-3.02, - 0.75，P=0.001) and operative time (MD=-2.03，95%CI：-2, 77, -1.29，P<0.00001) compared to the double-layer closure. There was no difference when it came to the impact of the risk of wound infection (RR=0.81，95%CI：0.73, 0.90，P=0.09), endometritis (RR=0.96，95%CI：0.74, 1.52， P=0.74), cesarean scar defects (RR=1.93，95%CI：0.12, 30.43，P=0.64) and uterine scar dehiscence (RR=1.82，95%CI：0.56, 5.91，P=0.32) in next pregnancy. Conclusions There was no significant difference in the short-term effect between the different ways of the closure of the peritoneum and uterus
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Background Cancer occurs in approximately 1:1000 pregnancies. When chemotherapy cannot be delayed until postpartum, beginning chemotherapy is based on presumed safety after organogenesis is completed during the first trimester. The safest gestational age to start chemotherapy after the first trimester is unknown. Patients and Methods In an observational cohort of pregnant women diagnosed and treated for cancer at multiple centers, pregnancy outcomes for the mother, and clinical outcomes for the neonate were analyzed according to the gestational age in weeks of pregnancy at first chemotherapy cycle. Outcomes including birth weight, fetal growth restriction, congenital malformations, and perinatal complications for mother and infant were analyzed according to gestational age of chemotherapy initiation. Neonatal growth, general health and developmental assessment were provided annually by each child’s pediatrician. For each outcome, cut-point of gestational age at first chemotherapy after 12 weeks was determined with odds ratios (OR). Results Data from 225 women (231 fetuses) were analyzed. Initiating chemotherapy before 15 weeks GA significantly increased risk for intrauterine growth restriction (OR=3.0), before 16.6weeks GA increased risk for congenital anomalies (OR=3.9), and before 18 weeks GA increased risk for spontaneous preterm birth (OR=2.3). Maternal and neonatal complications during pregnancy or follow up were not statistically different based on GA when chemotherapy began. Conclusions During the second trimester, the ideal time to start chemotherapy should consider maternal benefit versus neonatal risk. With a history of spontaneous preterm birth in a prior pregnancy, delaying chemotherapy until 18 weeks may decrease recurrent preterm birth, if not detrimental to the mother. The risk for fetal growth restriction increased with chemotherapy initiation before 15 weeks, and for congenital malformations before 17 weeks.
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We present a case of choriocarcinoma treated by high-intensity focused ultrasound (HIFU) combined with hysteroscopic and chemotherapy. Initially, retained placenta accreta or gestational trophoblastic disease was suspected, After HIFU treatment, obvious bleeding during hysteroscopic surgery, and the β-HCG level decreased. Degeneration and necrotic cells can be seen in the HIFU area. And we give the patient 5 cycles of intravenous EMA/CO chemotherapy. The patient was stable after chemotherapy. The last follow-up time is December 14, 2018, the patient did not complain of discomfort, and the serum β-hCG results were normal.
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A 30-year old female Caucasian patient complained left lumbar pain. Ultrasonography revealed a heterogeneous ovarian mass of 148mm3 progressively over at least 4 months to 248mm3. She had a history of unsuccessful attempts to become pregnant and one previous full abortion
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Preeclampsia is a common disorder that affects approximately 2 to 8 percent of pregnancies world-wide. Screening for preeclampsia in the first trimester yields high detection rates for low screen positive rates screen-positive rate (the number of patients informed that their test is abnormal). The risk of preeclampsia can be reduced by daily administration of low-dose aspirin to women at high risk of developing this disorder if treatment is started early in pregnancy.
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