A 31-year-old woman, with a history of previous cesarean section and right oophorectomy, was admitted for a repeat cesarean section. After the commencement of surgery uterine torsion was diagnosed because of the anterior position of the remaining left ovary and tube, the absence of normal uterovesical peritoneum, and extremely engorged vessels in the lower uterine surface. Posterior classical hysterotomy was performed and a healthy female baby was delivered. Following delivery of the baby and suturing the incision site of the uterus, the contracted uterus was detorted and put back in the pelvic cavity. Extreme uterine torsion of 180 degrees at term is a rare obstetric event. This paper presents a case of uterine torsion at full term pregnancy in which the delivery and repositioning of the uterus was successful.
Adult ; Case Report ; Cesarean Section ; Female ; Human ; Infant, Newborn ; Pregnancy ; Pregnancy Complications* ; Torsion ; Uterine Diseases/surgery ; Uterine Diseases/physiopathology* ; Uterine Diseases/etiology*

Hysteroscopic surgery is a minimally invasive procedure for the treatment of intrauterine pathologies. However, it can result in fatal complications. We herein report a case of symptomatic hyponatremia and hyperglycemia during hysteroscopic resection of severe intrauterine adhesion with 5% dextrose in water as the distension medium. Because of the difficulty of the incision, the infusion pressure was 100 to 150 mmHg, and surgery was continued for 70 minutes. A total of 19 L of 5% dextrose in water was used as an irrigating fluid. Large-scale absorption of irrigating fluid (3 L) induced dilutional hyponatremia (120 mmol/L) and hyperglycemia (30 mmol/L). Initial signs were abnormal flatulence and postoperative coma. Hypertonic saline, diuretics, insulin, and liquid restriction were the prevailing treatment strategies for hyponatremia and hyperglycemia. Ionized calcium and potassium levels decreased during treatment. We emphasize the importance of prevention, recognition, and a meticulous perioperative treatment standard. Surgical teams must be vigilant in fluid deficit monitoring and serum electrolyte analysis.
Adult ; Female ; Humans ; Hyperglycemia ; etiology ; Hyponatremia ; etiology ; Hysteroscopy ; adverse effects ; Intraoperative Complications ; etiology ; Tissue Adhesions ; Uterine Diseases ; surgery

To evaluate the long term effects of an IUD on the human endometrium and find the possible contraceptive mechanism of IUD, histologic, histochemical and ultrastructural studies of human endometrial biopsies from 44 normal controls and 178 IUD wearers were made. Histologic findings included interstitial hemorrhage, inflammatory reaction, hyperplasia, atrophy, focal necrosis and squamous metaplasia. However, all of these findings were either infreqnent or insignificant except for inflammatory reaction. Histochemica1, enzymatic and ultrastructural findings were a1so unremarkable. The most significant finding, was asynchronism between cyclic dating and endometrial histologic dating, showing delayed endometrial maturation in the majority of IUD users. In summary, IUD insertion brings about mild and little histologic alteration in the human endometrium, but the inflammatory reaction and asynchronous endometrial matruation may play some role in the antifertility actifertility action of an IUD.
Adult ; Comparative Study ; Endometriosis/etiology ; Endometriosis/ultrastructure ; Endometrium/ultrastructure* ; Female ; Human ; Intrauterine Devices/adverse effects* ; Middle Age ; Time Factors ; Uterine Diseases/etiology* ; Uterine Diseases/pathology

Radiation-induced arterial disease is caused by significant atherosclerosis in the circumjacent vessels being irradiated. Even though this has been recognized as survival of cancer patients treated with radiotherapy improves, it is a problem that is often under-reported. We present a case of chronic thromboembolic occlusion of right common iliac artery in a 53-year-old woman who was treated with radiation therapy for cervical cancer 13 years ago. We initially performed percutaneous transluminal angioplasty with thrombolytic therapy, but had to cease thrombolytic therapy due to upper gastrointestinal bleeding of Dieulafoy's lesion, nevertheless, achieved good results after revascularization by Fogarty embolectomy.
Arterial Occlusive Diseases/*etiology ; Female ; Humans ; Middle Aged ; Radiotherapy/*instrumentation ; Uterine Cervical Neoplasms/*radiotherapy

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

The pathogenesis and therapeutic treatment of intrauterine adhesions (IUAs) remain unsolved, highlighting the need for stable and effective experimental animal models. In this study, uterine electrocoagulation of twenty-one female New Zealand White rabbits was carried out to establish an IUA model. As rabbits have two completely separate uterine horns, each rabbit had its own internal control: one uterine horn was given an electrothermal injury (Group A, n=21), and the contralateral uterine horn received no treatment and served as the control (Group B, n=21). The endometrial morphology, number of endometrial glands, area of endometrial fibrosis, and number of implanted fetuses were compared between the two groups. In Group A, the numbers of endometrial glands on Days 7 and 14 and the number of implanted fetuses were significantly lower than those in Group B (P<0.05, P<0.05, and P<0.01, respectively), while the ratio of the area with endometrial stromal fibrosis to the total endometrial area was significantly increased (P<0.01). These results suggest that this method of electrothermal injury is effective for the establishment of a rabbit IUA model between 7 and 14 d after surgery.
Animals ; Disease Models, Animal ; Electrocoagulation ; Endometrium ; pathology ; Female ; Pregnancy ; Rabbits ; Tissue Adhesions ; etiology ; pathology ; therapy ; Uterine Diseases ; etiology

OBJECTIVETo investigate the reproductive track infection (RTI) situation and risk factors for cervical infection (Neisseria gonorrhoeae or Chlamydia trachomatis) among different kinds of women of childbearing age in Shenzhen city, China. To assess the feasibility of the syndromic approach for vaginal discharge.

METHODSThe survey was administrated to 4,744 eligible women in Shenzhen city during October 2001 and April 2002. The subjects included three different kinds of population: 3,895 cases of general population, 438 STD/gynecological clinic outpatients and 411 people with high risk behavior. Gynaecologic examination and RTI laboratory diagnosis were performed for each subject. PCR method-based test was used to detect the Neisseria gonorrhoeae and Chlamydia trachomatis infection. Standardized questionnaire were designed to collect the information about RTI related behaviors, and history of marriage and child bearing, et al. The risk factors, symptoms and signs of cervical infection were analyzed. Syndromic approach was established and its feasibility was assessed.

RESULTS27.6% of women in Shenzhen were infected with at least one kind of RTI, including 5.0% with cervical infection. The risk factors for cervical infection were: individuals having had new sex partner within last 3 months (OR = 1.6, 95% CI: 1.1 - 2.4), having had the experience of abortion (OR = 1.6, 95% CI: 1.1 - 2.4), aged 25 or less (OR = 1.6, 95% CI: 1.1 - 2.4) and never using condom during sex intercourse (OR = 1.7, 95% CI: 1.1 - 2.4). The sensitivity of syndromic approach of risk assessment and signs for cervical infection among general population was 63.8%, while specificity was 55.1% with the positive predictive value 7.0%.

CONCLUSIONSRTI infection was common among all three kinds of childbearing women in Shenzhen city. The prevalence of RTI was the highest among high risk population, followed by STD/gynecological clinic outpatients. The efficacy of syndromic approach for cervical infection in general population was not ideal.

China ; epidemiology ; Female ; Genital Diseases, Female ; epidemiology ; etiology ; Humans ; Risk Assessment ; Risk Factors ; Uterine Cervical Diseases ; epidemiology ; Vaginal Discharge ; epidemiology ; etiology

Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.
Aged ; Aged, 80 and over ; Case Report ; Colonic Diseases/etiology* ; Female ; Human ; Rectal Prolapse/complications* ; Rupture, Spontaneous ; Uterine Prolapse/complications*

OBJECTIVETo investigate the effects of hysteroscopic treatment of women with previous cesarean scar defect (PCSD).

METHODSFrom May 2006 to October 2008, 12 patients with PCSD were diagnosed and treated hysteroscopically in our hospital, all of them were successful followed-up for one year postoperatively, and their clinical data were analyzed.

RESULTSAll 12 hysteroscopic procedures were completed successfully, and there were no surgical complications. Nine patients with longer periods and 1 patient with intermenstrual spotting preoperatively remained asymptomatic after hysteroscopic surgery, and 1 patient with longer periods and infertility experienced normal periods, while remained infertility, and the remaining 1 patient complaining postcoital bleeding preoperatively had recurrence of the bleeding.

CONCLUSIONHysteroscopic surgery of women with PCSD was minimally invasive and effective.

Adult ; Cesarean Section ; adverse effects ; Cicatrix ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hysteroscopy ; Postoperative Complications ; surgery ; Uterine Diseases ; surgery

OBJECTIVE: To depict the cell landscape and molecular biological characteristics of human intrauterine adhesion (IUA) so as to better understand its immune microenvironment and provide new inspirations for clinical treatment. METHODS: Four patients with IUA who underwent hysteroscopic treatment at Dongguan Maternal and Child Health Care Hospital from February 2022 to April 2022 were selected as the study subjects. Hysteroscopy was used to collect the tissues of IUA, which were graded based on the patient's medical history, menstrual history and status of IUA. Library construction, sequencing, single cell data comparison and gene expression matrix construction were carried out in strict accordance with the single cell RNA sequencing process. Thereafter, the UMAP dimension reduction analysis of cell population and genetic analysis were carried out based on the cell types. RESULTS: A total of 27 511 cell transcripts were obtained from four moderately graded IUA tissue samples and assigned to six cell lineages including T cells, mononuclear phagocytes, epithelial cells, fibroblasts, endothelial cells and erythrocytes. Compared with normal uterine tissue cells, the four samples showed different cell distribution, and the proportions of mononuclear phagocytes and T cells in sample IUA0202204 were significantly increased, suggesting a strong cellular immune response. CONCLUSION The cell diversity and heterogeneity of moderate IUA tissues have been described. Each cell subgroup has unique molecular characteristics, which may provide new clues for further study of the pathogenesis of IUA and heterogeneity among the patients.
Pregnancy ; Female ; Child ; Humans ; Endothelial Cells ; Uterine Diseases/complications* ; Hysteroscopy/methods* ; Tissue Adhesions/etiology* ; Sequence Analysis, RNA