Background: The Lead Vessel and Infitrating Vessels are findings in endometrial cancer that are well visualized by three-dimensional power Doppler angiography. Vessel diameter and length may be utilized as markers for deep myometrial and or cervical involvement. Objective: To determine the accuracy of Lead vessel and Infiltrating vessel dimensions in assessing the depth of myometrial invasion in endometrial cancer and its cervical involvement. Participants and Methods All women histopathologically diagnosed with endometrial cancer, undergoing surgical staging, with informed consent were included. Sonography using GE Voluson S8 system for describing the uterus and endometrial thickness were followed by a 3D power Doppler Angiography to analyze the depth of myometrial invasion and presence or absence of cervical involvement. Vessel diameter and length in transverse and sagittal plane were measured by calipers. Predictive values and operating characteristics (sensitivity, specificity, positive and negative predictive values) were computed.
Myometrium ; Endometrial Neoplasms ; Angiography ; Ultrasonography, Doppler

<p style="text-align: justify;">Postpartum hemorrhage is a preventable event in abdominal and vaginal seliviries. Conventional incremental dosing or continous infusion of oxytocin has been employed for these. Carbetocin, as an anlogue is associated with longer half-life and has clinical benefits.p><p style="text-align: justify;">OBJECTIVE: The objective was to compare the effectiveness of carbetocin and oxytocin when administered after elective uncomplicated cesarean section (CS) for the prevention of postpartum hemorrhage.p><p style="text-align: justify;">DESIGN: Randomized single blind controlled trial of patients admitted at Rizal Medical Center from June to October 2012.p><p style="text-align: justify;">PARTICIPANTS AND METHODS: A total of 70 patients were randomized to carbetocin (n=35) and oxytocin (n=35) for the prevention of postpartum hemorrhage and analyzed by intention-to treat. Baseline demographic and obstetric profile, indications for CS, estimated blood loss, hematocrit, hemoglobin, need for uterine massage, additional uterotonics, uterine tone and involution were compared immediate post-operative and 24 hours after.p><p style="text-align: justify;">RESULTS: Baseline profiles were similar between the two groups. Post-operatively, hemoglobin and hematocrit levels in the carbetocin in group were statistically significant and were associated with lesser need for additional uterotonic agents, uterine massage and a well contracted uterus immediate post-operative and 24 hours thereafter. The estimated blood loss was significantly lower in the carbetocin group however , the two groups did not significantly differ in terms of blood transfusion requirements and post-op blood pressure.p><p style="text-align: justify;">CONCLUSION: Carbetocin as a uterotonic agent is an acceptable alternative for the prevention of postpartum bleeding in elective cesarean section. A cost-benefit analysis is mandated. p>
Human ; Female ; Carbetocin ; Oxytocin ; Postpartum Hemorrhage ; Blood Pressure ; Half-life ; Hematocrit ; Oxytocics ; Cesarean Section ; Postpartum Period

<p style="text-align: justify;">Labor induction is a common practice in obstetrics with 20% of term pregnancies induced annually, influenced by preinduction cervical ripening. Outpatient cervical ripening is of increasing interest but no preferred agent is used. Isosorbide mononitrate (IMN), a nitric oxide donor is a potential outpatient cervical ripening agent without unwanted side effects noted in several studies. A meta-analysis of 5 randomized controlled trials with 735 participants, comparing the effectiveness and safety of cervical ripening and labor induction by isosorbide mononitrate versus placebo was performed. IntravaginallMN 40mg compared with placebo increased the odds of women to go on labor within 24 hours (OR 2.6) and increased the odds of women to deliver vaginally (OR 1.02). However, IMN also increased the odds of cesarean delivery (OR 1.08) but, indications were not solely attributed to failed induction of labor. There was no significant difference between isosorbide mononitrate and placebo on neonatal outcome and admission. IMN caused hypotension and significantly increased risk of maternal headache but not severe to require treatment. Thus, isosorbide rnononltrate is a feasible outpatient cervical ripening agent that appeared to be effective and safe.p>
Cervical Ripening ; Nitric Oxide Donors ; Isosorbide ; Obstetrics ; Labor, Induced ; Isosorbide-5-mononitrate ; Isosorbide Dinitrate ; Cesarean Section ; Hypotension ; Headache

Adequate staging of pelvic organ prolapse is essential in clinical practice. Objectives: 1) To compare the results of gray scale transperineal ultrasound pelvic organ prolapse quantification with the Pelvic Organ Prolapse Quantification System and 2) Correlate result of sonologicprolapse assessment and POPQ. Study Design: A case series was done on 32 patients diagnosed with pelvic organ prolapse and who underwent vaginal hysterectomy withina 4 year period. Patients' charts were reviewed for age, gravidity, parity, physical activity, model of childbirth, clinical presentation of pelvic organ prolapse, assessment results of gray scale transperineal ultrasound and POPQ.Outcome Measure: 1) Clinical profile which include mean age, mean gravidity, mean parity, physical activity, mode of childbirth and manifestation of prolapse; 2) Comparison of proportion of patients by stage of prolapse by POPQ and compartment prolapse by transperineal ultrasound; and 3) Pearson's correlation of POPQ stages with descents of the bladder, cervix and recti ampulla. Results: Mean age of 60, mean gravidity of 5, 46.9 percent of patients had parity of more than 5 normal spontaneous deliveries. Majority had prolapsed vaginal mass at consult with stage 0 (3.1%), stage 1 (6.3%), stage 2 (12.5%), stage 3 (56.3%) and stage 4 (21.9%) organ prolapse by POPQ. Sonologic assessment noted single compartment prolapse (6.25%), 2 compartment prolapse (93.7%), mostly anterior and central.Bladder descent (r=0.320), cervix descent (r=0.37), and recti ampulla (r=0.404) showed good correlation with POPQ with Pearson's correlation, 1 tailed test, P value = 0.05.Conclusion: Gray scale transperineal ultrasound showed good correlation with POPQ System in the assessment of pelvic organ prolapse.
Human ; Female ; Aged ; Middle Aged ; Adult ; X