Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Oct 2014
ReviewManagement of the pregnant woman with Marfan syndrome complicated by ascending aorta dilation.
Marfan syndrome is a disorder of connective tissue associated with progressive dilation of the aorta and potential risk for aortic dissection. Women with Marfan syndrome who are, or wish to become, pregnant represent a unique and challenging patient population due to a risk for accelerated aortic growth and aortic dissection during pregnancy. Risk for aortic complications during pregnancy is related to the dimensions of the ascending aorta. Women with an aortic diameter ≥4.5 cm at the start of pregnancy are at higher risk for aortic dissection, and an aortic dimension >4.0 cm is considered a relative contraindication to pregnancy in the setting of Marfan syndrome. ⋯ Multidisciplinary care involving specialists familiar with Marfan syndrome should be emphasized before, during, and after pregnancy with the involvement of Maternal Fetal Medicine, Genetics, Cardiology, Cardiothoracic Surgery, Anesthesia, and other specialties on a case-by-case basis. We review the important aspects of the evaluation and management of pregnant women with Marfan syndrome.
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Arch. Gynecol. Obstet. · Sep 2014
Case ReportsHemostatic gelatine-thrombin matrix (Floseal®) facilitates hemostasis and organ preservation in laparoscopic treatment of tubal pregnancy.
Laparoscopic salpingotomy has become the gold standard for the treatment of tubal ectopic pregnancy (TEP). Limitations for organ preservation in TEP can result from intra-operative bleeding or potential tubal damage due to application of thermal coagulation. Hemostatic gelatine-thrombin matrix Floseal® allows effective local hemostasis when sutures or thermal coagulation are inadequate or impossible. ⋯ Hemostatic gelatine-thrombin matrix Floseal® minimizes tissue damage and optimizes local hemostasis. The use of Floseal® enhances the chance of organ preservation in the laparoscopic treatment of TEP.
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Arch. Gynecol. Obstet. · Aug 2014
Multicenter Study Comparative StudyInterest of human papillomavirus DNA quantification and genotyping in paired cervical and urine samples to detect cervical lesions.
Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. ⋯ High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.
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Arch. Gynecol. Obstet. · Aug 2014
Randomized Controlled TrialRandomized trial of long-term effects of percutaneous tibial nerve stimulation on chronic pelvic pain.
To evaluate the long-term effects of percutaneous tibial nerve stimulation (PTNS) on quality of life in women with chronic pelvic pain. ⋯ PTNS is a minimally invasive treatment method that leads to decrease in pain severity and improvement in quality of life in women with chronic pelvic pain with effects continuing at 6 months.
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Arch. Gynecol. Obstet. · Aug 2014
Randomized Controlled TrialEffect of local infiltration analgesia on post-operative pain following TVT-O: a double-blind, placebo-controlled randomized study.
To evaluate the effect of a protocol of local anesthesia and epinephrine associated with sedo-analgesia on post-TVT-O pain in comparison with infiltration of saline and epinephrine. ⋯ This randomized study seems to indicate that systematic infiltration before TVT-O positioning with local anesthetic may reduce immediate post-operative pain.