Journal Detail Information

1

Cite

Share

Cervical Intraepithelial Neoplasia Managed by Cold Knife Conization with Electrocautery Hemostasis by Hysteroscope: 193 Cases Analysis

Henan DENG ; Wei ZHANG

Journal of Practical Obstetrics and Gynecology.2010;26(4):282-285.

Objective:To evaluate the value of diagnosis and therapy of cold knife conization with electro-cautery hemostasis by hysteroscope in the treatment of ceNical intraepithelial neoplasia (CIN).Methods :A retrospective analysis of the clinical data was carried out in 193 cases with CIN underwent cold knife coniza-tion with electrocautery hemostasis by hysteroscope from January 2005 to November 2008, and all patients had pathological diagnosis under colposcopic biopsy.Results:The operative time was from 15 to 40 mi-nutes, and the blood loss dunng operation was from 5 to 25 milliliters.The coincidence rate of histopathology before and after conization was 67.88% in 131 cases.9 CIN Ⅲ patients had positive margins after opera-tion, owing to scab break off bleeding of cervical wound was encountered in 18 cases.No infection and cervi-cal adhesion or stenosis occurred.Conclusions :Cold knife conization with electrocautery hemostasis by hyst-eroscope is an effective diagnosis and treatment for CIN.

2

Cite

Share

The Relationship between Decision-to-Delivery Interval in Emergency Caesarean Sections and Neonatal Outcome

Xia LI ; Aiqing HU ; Houwen PANG

Journal of Practical Obstetrics and Gynecology.2010;26(4):276-278.

Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.

3

Cite

Share

Pulmonary Hypertension Complication Pregnancy : Analysis of 10 Cases

Lijuan ZHANG ; Hongbo ZENG

Journal of Practical Obstetrics and Gynecology.2010;26(4):268-271.

Objective:To analysis the clinical characteristics of pulmonary hypertension (PH) complicating pregnancy, then to explore the delivery time and the monitodng as well as the treatment during perinatal peri-od.Methods:The data of 10 cases with PH treated in our hospital from June 2005 to January 2009 were retro-spectively analyzed.Reaults:1 case was primary pulmonary hypertension(PPH) ; 9 cases were secondary PH (SPH), in which 4 cases were rheumatic heart disease and 5 cases were congenital heart diseases.3 cases were slight PH,6 cases were moderate PH, and 1 were severe group.4 cases NYHA class were Ⅰ～Ⅱ and 6 cases NYHA class were Ⅲ～Ⅳ.4 cases were term delivery,5 cases were premature delivery, and 1 got artifi-cial abortion.8 cases were cesarean section, and 1 was vaginal delivery.2 cases were very low birth weight infants, 1 infant was death and 1 mother was death.Conclusions:The patient of PPH should avoid concei-ving.For SPH patients whether to conceive depends on cardiac function, the level of pulmonary arterial pres-sure and should better get pregnancy after surgery or medication.It should terminate pregnancy in the first tri-mester for moderate or severe patients.Cesarean section is more suitable for those in the second or third tri-mester.The prognosis of the mother and neonate depends on several factors.

4

Cite

Share

Effect of Pregnancy and Delivery on the Pelvic Floor Function

Jian QU ; Xiaowei ZHANG

Journal of Practical Obstetrics and Gynecology.2010;26(4):304-306.

Objective:To investigate the change of petvic floor function in the third trimester of pregnancy and early postpartum.Methods :46 pregnant women in the third trimester in our hosprtal from July to October 2007 were randomly selected.In late pregnancy, 6 ～8 weeks and 12 ～14 weeks after delivery, the incidenca of stress urinary incontinence (SUI) and bladder neck mobility in different stage of puerperium was carried out.They were respectively given score, protectrve pad experiment, ultrasonic testing residual urine and peri-neum ultrasound examination.An anarysis on their.Results :The incidence of SUI that diagnosis by POP-Q or POP-Q combined with pat test was 47.83% ,39.13% respectively in late pregnancy group;21.74% ,15.22% in 6 ～8 weeks after delivery;17.24%.13.7g% in 12 ～14 weeks after delivery.The difference between late pregnancy group and 6～8 waeks after delivery group was statistical significance (P<0.05).There was no significantly difference between 6 ～8 weeks and 12 ～14 weeks after delivery groups(P>0.05).There was significant difference between 6 ～ 8 weeks and 12～14 weeks after delivery group while compared the bladder neck angle[(88.11± 13.36)° vs(82.17 ±10.28)°]with the bladder neck rotation angle[(21.67 ±10.64) ° vs (16.79±8.57) °].Conclusions :Pregnancy and delivery can damage the function of pelvic floor, which has certain rehabilitation after delivery.

5

Cite

Share

Surgery Intervention of Pregnancy Heart Disease

Fengzhen HAN ; Yang ZHAO ; Cong LU

Journal of Practical Obstetrics and Gynecology.2010;26(3):225-228.

Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

6

Cite

Share

Analyzing Complications of 73 Cases of Laparoscopic Gynecologic Surgery

Jun QIU ; Yuna GUO ; Huifang ZHONG

Journal of Practical Obstetrics and Gynecology.2010;26(3):212-215.

Objective:The causes, management, and prevention of complications in laparoscopic gyneco-logic surgery were investigated. Methods:A retrospective analysis was done based on clinical data of 8279 cases of laparoscopic gynecologic surgery from January 1996 to December 2008 in this hospital. Results:The complication rate was 0.88% (73/8279). These included five cases intraperitoneal bleeding, five cases injury of ureter, 20 cases abdominal vessel damage, 10 cases vulva emphysema, 25 cases wound healing delay and each one case respectively for stomach injury, bladder injury, secondary abdominal cavity preg-nancy,infection and incision hernia. The occurrence rates of complications between hysteroscopy combined with laparoscopic surgery and pure adnexal surgery were no difference( P >0.05). Compared to adnexal op-erations, there was a significantly higher complication rate in myomectomy and laparoscopic assistant vaginal hysterectomy (P < 0.01 ). Conclusions:Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operators. In order to reduce complications, careful oper-ation and avoiding over self -confidence are essential.

7

Cite

Share

The Analysis of Ultrasonic Classification and Treatment Effect for Cesarean Scared Pregnancy

Yuyan DENG ; Jing LU ; Ding SONG

Journal of Practical Obstetrics and Gynecology.2017;33(7):538-540.

Objective:To explore the ultrasonic classification in cesarean scared pregnancy (CSP)and its effect on guiding the clinical treatment.Methods:The clinical data of 41 patients with CSP in the Third people's hospital of Chengdu from January 2013 to January 2016 were analyzed retrospectively.Diagnosis was confirmed according to the diagnostic criteria for ultrasound imaging by Godin etal and the history of cesarean section.Patients were divided into type Ⅰ group and type Ⅱ group through measuring the outside uterine muscle layer thickness of pregnant bursa,based on the criteria by Vial et al.Type Ⅰ:MTX intramuscular injection followed by ultrasound guided Dilation and Curettage(D&C)3 days later.Type Ⅱ]:Uterine artery chemo-embolization (UACE)followed by ultrasound guided D&C 2 days later,or lesion resection and repair of the uterus by trans-abdominal or laparoscopic or trans-vaginal operations 2 days later.Results:The outside uterine muscle layer of pregnant bursa in type Ⅱ] was more thinner than that in type Ⅰ (2.1 ± 1.1 mm vs 3.7 ±0.6 mm,P ＜ 0.05).The number of abortion in type Ⅱ was more than that in type Ⅰ (2.8 ± 0.7 vs 1.5 ± 0.6,P ＜ 0.05).There were no statistically significant differences in age,amenorrhea duration and the number of cesarean section (P ＞ 0.05).Patients from two group were treated successfully,and there was no statistical significance about,intraoperative bleeding volume,preoperative serum levels of β-HCG and average recovery time of serum β-HCG(P＞0.05).The average hospital stays and cost in type Ⅰ were less than that in type Ⅱ,with statistical significance (4.7 ± 2.5 vs 8.6 ± 2.7 days,5234.6 ± 1688.8 vs 15668.4 ±4623.4 RMB,P ＜ 0.05).Conclusions:The ultrasonic classification of CSP plays a directive role in making treatment option,with reliabe effect and the good prognosis.UACE as a pretreatment which can control intraoperative bleeding,is an effective method for CSP.For its higher cost,UACE should be selectively used in type Ⅱ[CSP,with cost-effective.MTX intramuscular injection used in type Ⅰ CSP before D&C is reliable and cost-effective.

8

Cite

Share

Clinical Observation of Lung Protective Ventilation Strategy in Gynecologic Laparoscopic Surgery

Hengyu CAI ; Hongyan GAO

Journal of Practical Obstetrics and Gynecology.2017;33(7):534-537.

Objective:By monitoring the lung compliance,oxygenation index(OI),CC16、IL-8 in plasma,observe whether the protective lung ventilation in patients undergoing gynecological laparoscopic surgery can improve the respiratoryw function and reduce lung injury.Methods:40 cases of ASA grade Ⅰ-Ⅱ were selected,and 40 patients were treated by elective laparoscopic radical resection of cervical cancer.The patients were divided into two groups according to the random number table method in 40 cases.Mechanical ventilation in general anesthesia,A group used traditional intermittent positive pressure ventilation mode,tidal volume is set to 10ml/KG (PBW);B group used lung protective ventilation strategy,tidal volume is set to 6ml/KG (PBW) + 5cmH2O PEEP + recruitment manoeuvres.For patients before pneumoperitoneum(T0),2 hours after pneumoperitoneum (T1),4 hours after pneumoperitoneum (T2)MAP,HR,CVP,RR and C were observed.In pneumoperitoneum (T0),2 hours after pneumoperitoneum(T1),4 hours after pneumoperitoneum (T2),2 hours after operation(T3),24 hours after surgery(T4) venous,IL-8,CC16 content detection.Results:Before pneumoperitoneum,two groups of patients with pulmonary compliancethe difference was statistically significant(P ＜0.05).Compared T1 、T2 with T0 in A group and B group,the pulmonary compliance all decreased and there existed significant deference(P＜0.05).Notably,A group decreased evidently(P＜0.05).T0,T1,T3,T4 time points in two groups of patients with oxygenation index,the difference was statistically significant (P ＜ 0.05).Two groups of patients with CC16,IL-8content in T1,T2,T3,T4 time point,the difference was statistically significant (P ＜ 0.05).Conclusions:Lung protective ventilation strategy can improve respiratory function in patients with gynecological laparoscopic surgery,and reduce the incidence of lung injury.

9

Cite

Share

Expression and Clinical Significance of ALDH1 and ABCG2 in Cervical Cancer Cells

Yan LIU ; Jing BAI ; Aijun LI

Journal of Practical Obstetrics and Gynecology.2017;33(3):206-209.

Objective:To detect the expression of ALDH1 and ABCG2 in the specimens from different levels of cervical lesions.Methods:Use SP immunohistochemistry to detect the expression of ALDH1 and ABCG2 in 76 cases of cervical squamous cancers,52 cases of HSIL,and 37 cases of chronic cervicitis tissues,and analyze the results.Results:①The positive expression rates of ALDH1 and ABCG2 in chronic cervicitis tissues were 5.41％ (2/37) and 8.11％ (3/37),in HSIL tissues were 23.08％ (12/52) and 28.85％ (15/52),and in cervical cancers tissues were 53.95％ (41/76) and 61.84％ (47/76),respectively.The positive expression rates in cervical cancers tissues were significantly higher than in HSIL and Cc hronic cervicitis tissues,(P ＜ 0.05).②The positive expression of ALDH1 in cervical cancer tissues had correlation with tumor grade and lymphnode metastasis (P ＜0.05),while the positive expression of ABCG2 in cervical cancer tissues had correlation with tumor grade,clinical stage and lymph-node metastasis(P ＜0.05).③The expressions of ALDH1 and ARCG2 in cervical cancer were positive relative(r =0.535,P ＜ 0.05).Conclusions:The increased expressions of ALDH1 and ABCG2 in cervical squamous cancer may play a role in the occurrence,development and metastasis of cervical squamous cell carcinoma.ALDH1 and ABCG2 may have synergistic effect in occurrence of cervical cancer.

10

Cite

Share

Analysis of Diagnostic Differences between Colposcopy Beginner and Pathologic Report in Cervical Disease

Xia TAO

Journal of Practical Obstetrics and Gynecology.2017;33(3):198-202.

Objective:To evaluate the consistency of colposcopy diagnosis performed by a single examiner with pathologic diagnosis and to analyze the factors related with colposcopy over-and under diagnosis.Methods:A retrospective study was performed.The initial 200 cases diagnosed by a single colposcopy beginner at Peking University first Hospital out-patient clinic from March 2015 to October 2015 were included in this study.The consistency rate and bias rate of colposcopy diagnosis versus pathologic diagnosis as well as the causes of such differences were analyzed.Results:Of 174 cases with pathologic diagnosis,the consistency rate was 59.2％.The underdiagnosis rate and overdiagnosis rate were 18.4％ and 22.4％ separately.Of HSIL underdiagnosis group,the rate of TCT NILM was 78.6％ which was higher than 18.1％ in HSIL consistency group,P ＜ 0.05.Re-evaluation of the colposcopy pictures revealed that acetowhite epithelium were present in all 14 cased of HSIL underdiagnosis group.The rate of post-menopausal women was higher in HSIL underdiagnosis group than in HSIL consistency group(21.4％ vs 0％),P ＜0.05.The medium numbers of biopsy were higher in HSIL consistency group when compared with HSIL underdiagnosis group,P ＜0.05.The medium numbers of biopsy was higher in overdiagnosis group when compared with consistency group,P ＜ 0.05.Conclusions:Underdiagnosis of colposcopy was related with TCT-overdependent,insufficient understanding of acetowhite epithelium and post-menopausal women.Increasing biopsy numbers may improve the consistency rate of colposcopy and pathologic diagnosis.However,the increasing numbers of biopsy often results from overdiagnosis.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share