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Air Embolism: A Severe Complication of Hysteroscopic Surgery
Mengyue Chen,
Mengru Zhao,
Yun Yang,
Huimin Tang,
Zhenyue Qin,
Junling Liu,
Huihui Wang,
Mingyue Bao,
Jiming Chen,
Bairong Xia
Issue:
Volume 10, Issue 4, July 2022
Pages:
171-175
Received:
25 May 2022
Accepted:
3 July 2022
Published:
13 July 2022
DOI:
10.11648/j.jgo.20221004.11
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Abstract: Air embolism is one of the complications of hysteroscopy. When air enters the circulatory system to block blood vessels, it will lead to embolism, and even endanger the life of patients in serious cases. The prognosis of patients can be significantly improved through the rapid diagnosis and timely treatment of air embolism. Since most air embolism is iatrogenic, operators should not only make preoperative preparations, but also be familiar with the symptoms and signs of air embolism. Once air embolism is suspected, the operator must immediately observe the patient's vital signs and hemodynamics and immediately stop the operation and carry out treatment to prevent further deterioration of the condition when the situation is critical. Based on the clinical cases of air embolism in recent years and relevant research and analysis, this paper summarizes the pathogenesis, clinical manifestations, auxiliary examination, prevention and treatment of air embolism, so as to provide reference for clinical prevention and treatment of air embolism.
Abstract: Air embolism is one of the complications of hysteroscopy. When air enters the circulatory system to block blood vessels, it will lead to embolism, and even endanger the life of patients in serious cases. The prognosis of patients can be significantly improved through the rapid diagnosis and timely treatment of air embolism. Since most air embolism ...
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Post Caesarean Uterine Scar Dehiscence: A Case Report and a Short Review of Literature
Gunjan Bahuguna,
Naheeda Shaikh,
Ashok Anand,
Pratyasha Swain,
Rajashree Thatikonda
Issue:
Volume 10, Issue 4, July 2022
Pages:
176-182
Received:
1 June 2022
Accepted:
4 July 2022
Published:
13 July 2022
DOI:
10.11648/j.jgo.20221004.12
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Abstract: There has been a rise in lower segment caesarean sections in modern obstetrics with the prevalence being 21.5% in India according to NFHS-5. With the rise in LSCS, there has been also been a rise in risks and complications associated with it. We are going to discuss one such complication of infected uterine incisional necrosis and dehiscence after caesarean delivery, and a brief review of risk factors, pathophysiology and the management of this postpartum complication. Diagnosis can be done using methods such as ultrasonography, magnetic resonance imaging, and computer-aided tomography. Treatment includes resuturing the uterine incision line, hysterectomy, or conservative treatment accompanied by broad-spectrum antibiotics administration. We evaluated 2 cases one of which presented as puerperal sepsis and was diagnosed with the help of USG and CT and was surgically managed by debridement of infected and necrosed tissue and reconstruction of uterine rent along with broad spectrum antibiotics. The other case presented to us as puerperal sepsis, secondary post-partum hemorrhage and acute kidney injury that was diagnosed by ultrasound as a dehiscent scar postpartum after caesarean section and was managed surgically by obstetric hysterectomy. Both the cases were high risk and required prompt diagnosis and management. A study of various presentation of post caesarean uterine scar dehiscence and the methods of management is been discussed so as to aid in prompt diagnosis and appropriate management can be done with good outcomes. Post Ceaserean uterine scar dehiscence can be managed conservatively or surgically, tailored to the patient attributes with a good outcome.
Abstract: There has been a rise in lower segment caesarean sections in modern obstetrics with the prevalence being 21.5% in India according to NFHS-5. With the rise in LSCS, there has been also been a rise in risks and complications associated with it. We are going to discuss one such complication of infected uterine incisional necrosis and dehiscence after ...
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From Incurable to Preventable, the Success Story of Cancer of the Uterine Cervix
Issue:
Volume 10, Issue 4, July 2022
Pages:
183-185
Received:
5 July 2022
Accepted:
20 July 2022
Published:
28 July 2022
DOI:
10.11648/j.jgo.20221004.13
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Abstract: Background: Until late 19th century, cancer of the uterine cervix was deemed incurable due to lack of effective treatment. With the introduction of anesthesia and disinfection surgical management was dared. Around 1895 Professor Wertheim of Vienna, introduced his technique of radical hysterectomy. Around that time X-rays was discovered in 1895 and radium in 1898. Both surgery and radiation therapy became available for the treatment of cervical cancer. Objective: Although in time both surgery and radiation therapy evolved with technical refinement as effective treatment, yet the major impact was in early diagnosis with the introduction of the pap smear cytology. More recently, the discovery of the relationship between human papilloma virus infection and cancer of the uterine cervix resulted in the development of an effective vaccine for preventing the disease. Conclusion: HPV vaccination has almost successfully prevented cancer of the uterine cervix in younger women.
Abstract: Background: Until late 19th century, cancer of the uterine cervix was deemed incurable due to lack of effective treatment. With the introduction of anesthesia and disinfection surgical management was dared. Around 1895 Professor Wertheim of Vienna, introduced his technique of radical hysterectomy. Around that time X-rays was discovered in 1895 and ...
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Low Maternal 25(OH)D (Vitamin D) Serum Levels as a Risk Factor for Preterm Labor
David Eriandi Ginting,
Anak Agung Gede Putra Wiradnyana,
Ketut Suwiyoga
Issue:
Volume 10, Issue 4, July 2022
Pages:
186-189
Received:
18 June 2022
Accepted:
20 July 2022
Published:
29 July 2022
DOI:
10.11648/j.jgo.20221004.14
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Abstract: Preterm birth is the biggest cause of mortality in children under 5 years old in the world. The main causes of preterm birth are inflammation and intrauterine infection. Vitamin D plays a role in preventing preterm birth by reducing the oxidative stress of tissues that causes an inflammatory reaction. The purpose of this study is to determine that low maternal Vitamin D serum level as a risk factor for preterm delivery. This study is an analytic study with case control design with 54 samples, and divided into two groups, 27 preterm delivery samples as a case group and 27 preterm pregnancy samples as a control group. This research was conducted at the Obstetric and Gynecology Outpatient Clinic and the delivery room at Sanglah Hospital Denpasar during December 2018 to April 2019. The results of this study found a statistically significant difference (p = 0.028) between the case and control groups. Low vitamin D levels are a risk factor for preterm labor by 3.45 times compared with patients with high vitamin D levels (OR = 3.45, 95% CI = 1.12-10.67, p = 0.028). The conclusion of this study was that low maternal 25(OH)D (Vitamin D) serum levels is a risk factor for preterm deliveries.
Abstract: Preterm birth is the biggest cause of mortality in children under 5 years old in the world. The main causes of preterm birth are inflammation and intrauterine infection. Vitamin D plays a role in preventing preterm birth by reducing the oxidative stress of tissues that causes an inflammatory reaction. The purpose of this study is to determine that ...
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A Seven Year Review of the Management of Abortion Cases in Kogi State Specialist Hospital, Lokoja, Nigeria
Issue:
Volume 10, Issue 4, July 2022
Pages:
190-195
Received:
11 July 2022
Accepted:
25 July 2022
Published:
29 July 2022
DOI:
10.11648/j.jgo.20221004.15
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Abstract: Despite restrictive abortion law in Nigeria, unsafe abortion for unintended pregnancies is on the increase and remains a serious concern to the health of women. The aim of this review is to highlight the management outcome of abortion cases in a tertiary health facility in a developing nation. The study was a retrospective review of demographic characteristics of patients, clinical presentations, diagnosis and treatment of abortion cases managed at the Kogi State Specialist Hospital, Lokoja, Nigeria between January 1, 2012 and December 31, 2018. Data collected were analysed using SPSS window version 20.0 statistical package. A total of 233 abortion cases were managed. Out of these 62 (26.6%) cases were from complications from induced abortions while 171 (73.4%) were other types of abortions. Majority of the patients were between 26 - 30 years (39.3%) of age. Majority of the induced abortion cases were done by Christian faithful 54 (60.6%) while 35 (39.3%) of the patients were Muslim. About 79 (88.7%) of the patients were married while 10 (11.3%) were single. All patients had standard abortion care services. There was no case of maternal mortality from abortion complications throughout the seven years under review. Unsafe abortion for unintended pregnancies remains a reproductive health problem among our women and improvement in access to contraception services, provision of safe abortion and post abortion care services may help reduce maternal morbidity and mortality.
Abstract: Despite restrictive abortion law in Nigeria, unsafe abortion for unintended pregnancies is on the increase and remains a serious concern to the health of women. The aim of this review is to highlight the management outcome of abortion cases in a tertiary health facility in a developing nation. The study was a retrospective review of demographic cha...
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Molecular Diagnosis of Toxoplasma Gondii in Fetoplacental Tissue of Women with Miscarriage and Assessment of Risk Factors for Toxoplasmosis
Tamanna Ferdous Reza,
Shahanara Chowdhury,
Nasreen Banu,
Abu Mohammad Abdul Momen Zonaed Siddiki
Issue:
Volume 10, Issue 4, July 2022
Pages:
196-202
Received:
14 July 2022
Accepted:
26 July 2022
Published:
4 August 2022
DOI:
10.11648/j.jgo.20221004.16
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Abstract: Congenital toxoplasmosis is an important cause of miscarriage worldwide. There is high seropositivity of T. gondii among pregnant women in Bangladesh. The aims of the study were to estimate the presence of T. gondii in fetoplacental tissue among women with miscarriage and assess risk factors for toxoplasma infection in pregnant women. This cross-sectional study was performed for a period of one year on 138 patients. Obstetric parameters; cat, food, and soil related risk factors for toxoplasmosis were recorded and PCR analysis of fetoplacental tissue was performed for B1 and GRA6 gene in fetoplacental tissue by conventional PCR analysis. Comparisons were made between PCR positive and negative patients with regards to presence of risk factors for toxoplasmosis using Chi-square test or Fisher’s exact for categorical data; and t test or Mann Whitney U test for continuous data where appropriate. Among a total of 138 patients with miscarriage, 38 patients’ fetoplacental tissue (27.5%) were found to be positive for T. gondii. Age ranged from 18 to 37 years, mean 25 (±5) years. Living in a neighborhood with a cat was the only significant risk factor associated with PCR positivity (P=0.03). Other cat related factors and exposure to other animals were not related to PCR positivity. T. gondii was present in about one-fourth women with miscarriage at a tertiary hospital which demands further research.
Abstract: Congenital toxoplasmosis is an important cause of miscarriage worldwide. There is high seropositivity of T. gondii among pregnant women in Bangladesh. The aims of the study were to estimate the presence of T. gondii in fetoplacental tissue among women with miscarriage and assess risk factors for toxoplasma infection in pregnant women. This cross-se...
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Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure
Gamal Hassan Eltabbakh,
Samantha Gregoire,
Georgia Danine Eltabbakh
Issue:
Volume 10, Issue 4, July 2022
Pages:
203-210
Received:
16 July 2022
Accepted:
1 August 2022
Published:
10 August 2022
DOI:
10.11648/j.jgo.20221004.17
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Abstract: Objective: To compare the outcome of patients with uteri > 250 gm who had minimally invasive hysterectomy (MIH) to those who had abdominal hysterectomy (AH) using the LigaSure, stratify complications based on the uterine weight and report follow-up of patients who had vaginal morcellation. Study Design: A retrospective cohort study comparing patients with uteri > 250 gms who underwent vaginal hysterectomy (VH), laparoscopically assisted vaginal hysterectomy (LAVH) and robotic total laparoscopic hysterectomy (RTLH) to those who underwent AH. In both groups the LigaSure was used. Patients who had vaginal morcellation were followed-up. Results: A total of 166 patients were included: 10 patients had VH, 81 patients had LAVH, 22 patients had RTLH, and 53 patients had AH. Six (5%) MIH were converted to AH. Sixty-four percent of patients who needed hysterectomy were able to have successful MIH. Both groups were similar regarding age, American Society of Anesthesiologists score, previous laparotomy, previous C sections, body mass index, estimated blood loss, operative and postoperative complications, and final pathology report. The conversion and complication rates increased with uterine weight > 1000 gm. Patients who had AH had larger uteri and stayed in the hospital longer than those who had MIH. Thirty patients had vaginal morcellation with no consequences. Conclusion: Most patients with a large uterus could have save MIH with shorter hospital stay. Conversion and complications increase for uteri larger than 1000 gm. Vaginal morcellation had no consequences and the use of LigaSure provided adequate hemostasis.
Abstract: Objective: To compare the outcome of patients with uteri > 250 gm who had minimally invasive hysterectomy (MIH) to those who had abdominal hysterectomy (AH) using the LigaSure, stratify complications based on the uterine weight and report follow-up of patients who had vaginal morcellation. Study Design: A retrospective cohort study comparing patien...
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Venous Trhomboembolic Diseases in Gestants Followed at the Centre Médical Diamant in Lubumbashi: Analysis of Diagnosis and Therapeutic Elements
Mubinda Kiopin Patrick,
Augustin Kibonge Mukakala,
Iteke Fefe Rivain,
Shaddy Mahfoud,
Muanda Panzu Patrick,
Mwape Besa Baltfazar,
Prosper Kalenga Muenze
Issue:
Volume 10, Issue 4, July 2022
Pages:
211-216
Received:
1 February 2022
Accepted:
16 March 2022
Published:
24 August 2022
DOI:
10.11648/j.jgo.20221004.18
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Abstract: Pregnancy is one of the main risk factors for the development of venous thromboembolic disease (VTED). The objective of this work was to analyze the diagnostic and therapeutic elements of venous thrombosis in pregnant women followed at the Centre médical Diamant in Lubumbashi (CMDL). This is a descriptive cross-sectional study over a period of 27 months at CMDL in DR Congo, including all pregnant women followed for venous thrombosis during the study period. Data analysis was done by SPSS 22.0 software. The prevalence of VTED was 5.2% with a mean age of 27 ± 3 years (Extreme: 21 to 42 years). The telltale signs were dominated by asymmetric swelling of the lower limb (27.3%) and the main location was femoro-popliteal (63.6%). Superficial venous thrombosis was predominant with 54.5%. The diagnosis of VTE was supported by measurement of D-dimer in 100% of cases, confirmed by Doppler ultrasound in 81.8% of cases. Associated factors were non-O blood group (45.5%), history of miscarriages (27.3%), family history (18.2%), age over 35 years (18.2%), multiparity (27.3%) and gestational diabetes (18.2%). The treatment combined low molecular weight heparin in 72.7%. The mean duration of treatment was 28 days (range: 18-42 days). The outcome was favorable in 63.6% of cases. Venous thrombosis in pregnancy remains a major challenge in our environment because the risk factors and specific determinants are not known, there is no preventive or curative protocol adapted to our working conditions. Further, more in-depth studies are needed to optimize and rationalize care.
Abstract: Pregnancy is one of the main risk factors for the development of venous thromboembolic disease (VTED). The objective of this work was to analyze the diagnostic and therapeutic elements of venous thrombosis in pregnant women followed at the Centre médical Diamant in Lubumbashi (CMDL). This is a descriptive cross-sectional study over a period of 27 m...
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