European journal of obstetrics, gynecology, and reproductive biology
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Jun 2016
Risk factors for residual disease after cervical conization in patients with cervical intraepithelial neoplasia grades 2 and 3 and positive surgical margins.
To evaluate risk factors for the persistence of cervical intraepithelial neoplasia (CIN) grade ≥2 following repeat surgical procedures in patients with CIN grades 2 and 3 and positive surgical margins. ⋯ As lesions requiring multiple sweeps for excision and/or surrounding ≥50% of the cervical circumference during initial conization are associated with recurrent CIN ≥2 lesions, attention should be paid during resection to prevent margin positivity. If surgical margins are positive, however, repeat surgical procedures should be considered in patients with CIN 2 and CIN 3 lesions and these risk factors.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · May 2016
Prevalence and trends of pelvic floor disorders in late pregnancy and after delivery in a cohort of Israeli women using the PFDI-20.
To investigate the prevalence of pelvic floor disorders (PFD) in a cohort of Israeli women at late pregnancy and three months postpartum, to define changes in PFD rates and to evaluate various obstetrical factors that may correlate with these changes. ⋯ We have demonstrated that PFD is prevalent both in late pregnancy and in the puerperium. There are mixed trends of spontaneous recovery following childbirth. A significant association between perineal tears and SUI 3 months after delivery was noted.
-
Capturing 'near miss' and severe maternal morbidity using standard definitions is challenging. Information about levels of care required by ill pregnant or recently pregnant women may be more informative. The aim of this study was to prospectively audit incidence, causes, categorisation of maternal morbidity and level of care required by patients admitted to a labour ward high dependency unit (HDU) in a stand-alone obstetric hospital. ⋯ Approximately one quarter of women requiring HDU care 'lie beneath' criteria for near miss or severe maternal complications. One third of women admitted to the HDU require Level 2 care and the remainder require higher levels of monitoring only. The majority of cases are antepartum and delivery is integral in their care. HDU care in a labour ward setting is a good model for care of the ill pregnant or recently pregnant woman.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Mar 2016
Practice GuidelinePostpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF): in collaboration with the French Society of Anesthesiology and Intensive Care (SFAR).
Postpartum haemorrhage (PPH) is defined as blood loss ≥500mL after delivery and severe PPH as blood loss ≥1000mL, regardless of the route of delivery (professional consensus). The preventive administration of uterotonic agents just after delivery is effective in reducing the incidence of PPH and its systematic use is recommended, regardless of the route of delivery (Grade A). Oxytocin is the first-line prophylactic drug, regardless of the route of delivery (Grade A); a slowly dose of 5 or 10 IU can be administered (Grade A) either IV or IM (professional consensus). ⋯ If PPH is not controlled by pharmacological treatments and possibly intra-uterine balloon, invasive treatments by arterial embolization or surgery are recommended (Grade C). No technique for conservative surgery is favoured over any other (professional consensus). Hospital-to-hospital transfer of a woman with a PPH for embolization is possible once hemoperitoneum is ruled out and if the patient's hemodynamic condition so allows (professional consensus).
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Mar 2016
Elastosonographic evaluation of patients with a sonographic finding of thickened endometrium.
To evaluate if elastosonography of the endometrium can differ between normal endometrial tissue and abnormal pathology. ⋯ The elasticity of endometrial tissue, measured non-invasively via elastosonography, was similar in women with endometrial polyps and endometrial hyperplasia, but differed significantly compared with women with normal pathology who had a sonographic finding of thickened endometrium and abnormal bleeding as the presenting complaint. According to these results, elastosonography cannot be used as a diagnostic tool to differentiate between endometrial hyperplasia and endometrial polyps. However, elastosonography can be used to differentiate between pathological endometrial changes and normal endometrium in patients presenting with a sonographic finding of thickened endometrium.