ABSTRACT
It is believed that all kinds of gynaecological diseases are mostly related to deficiency and stagnation of qi and blood. Medicinal insects are good at running and scurrying， with the effectiveness of activating blood circulation and dispelling blood stasis， moving qi and relieving pain， searching and dredging collaterals， attacking hardness and dissipating mass， and purging foetus and resolving mass， etc. Appropriate prescriptions can enhance the effectiveness of the formula in eliminating blood stasis and eliminating stagnation. In the treatment of menstrual disorders， chronic pelvic inflammatory disease， uterine cavity disease， incomplete miscarriage， ectopic pregnancy， and other gynaecological diseases， medicinal insects including Quanxie （Scorpio）， Wugong （Scolopendra）， Tubiechong （Eupolyphaga/Steleophaga）， Jiuxiangchong （Coridius chinenses）， Shuizhi （Hirudo）， Mangchong （Tabanus）， Dilong （Pheretima） and other insects for medicinal purposes could be used， and the self-prescribed empirical formulas such as Sanhuang Decoction （三黄汤）， Hongteng Decoction （红藤汤）， Penning Decoction （盆宁方）， Shapei Decoction （杀胚方）， and Gongwaiyun Decoction （宫外孕方） and so on， were all applied medicinal insects and showed effective in clinic.
ABSTRACT
The uterus starts shrinking after giving birth and returns to its size prior to pregnancy one month postpartum. However, absence of this natural shrinking is called uterine subinvolution. There are two types of subinvolution : organic and functional. Removal of the cause is the first option for organic subinvolution. Conversely, most cases of functional subinvolution require drug treatment. This study included patients with subinvolution caused by accumulation of lochia with a uterine cavity width of 15 mm or more during a 14-day postpartum checkup. These patients were categorized into the control, keishibukuryogan, and ergometrine maleate groups ; therapeutic intervention was performed. A comparative study was conducted to determine the presence of subinvolution during the 1-month medical screening. There was no difference in the rate of uterine cavity shrinkage between the ergometrine maleate group and the control group. However, the keishibukuryogan group had a significantly higher reduction rate than the ergometrine maleate group. Furthermore, the keishibukuryogan group showed a tendency of higher shrinking rate when compared with the control group (76.1 ± 17.1% vs 65.8 ± 25.4%, 68.3 ± 22.9%, p = 0.0101, p = 0.0709). Additionally, no difference in the reduction rate of the fundal height was noted among the groups. These results suggest that although keishibukuryogan has little effect on reducing the uterine size, however, it has the effect of lochia accumulated within the uterine cavity.
ABSTRACT
Background: Hysteroscopy is the process of viewing and operating in the endometrial cavity from a transcervical approach. A camera is commonly attached to the proximal end of the hysteroscope to broadcast the image onto a large video screen. The development of hysteroscopy is rooted in the work of Pantaleoni, who first reported uterine endoscopy in 1869. However, at that time, instrumentation was elementary, and expansion of the uterine cavity was insufficient. In 1925, Rubin first used CO2 to distend the uterus. The use of liquid distention media became routine by the 1980s, and many new hysteroscopic procedures, including endometrial ablation, were developed.Methods: This was a retrospective study which presents the results of hysteroscopic treatment of various gynecological diseases in Cantonal hospital Travnik, Bosnia and Herzegovina in the period from 2011 to 2019. Total 175 cases were enrolled. All underwent hysteroscopic surgery in general anesthesia. The results were statistically analyzed.Results: Total number of patients is 175. The incidence is highest in the age 31-50 years (62%). Endometrial polyp is the most common pathological condition in 80%, myoma submucosum in 5,7%, and septum uteri 2,8%. The most common treatment was polypectomy 80%, then resection of submucosal myoma 5,7%, and extraction of IUD 4%.Conclusions: Hysteroscopy involves a minimal damage to body tissues. It is safer than open surgery. Hysteroscopic treatment has contributed to faster treatment, faster recovery and reducing the cost of treatment, and thus raise the level of efficiency.
ABSTRACT
Hemorrhage often occurs during caesarean section,which can lead to severe postpartum hemorrhage if not treated in time.Effective treatment can avoid serious bleeding and following complications.This paper discussed the advantages and disadvantages of various hemostasis schemes,which included uterotonics,uterine cavity tamponade,uterine compression suture,and vascular occlusion.Any hemostasis selected should be used as early as possible to achieve sufficient effect and reduce the morbidity of complications after massive hemorrhage.
ABSTRACT
Endometrial uterine sarcoma is a very rare tumour of the uterine cavity with an incidence of 1-2 cases per 100,000 women. Low grade Endometrial stromal sarcoma (LGESS) is an occasional diagnosis in a patient presenting as leiomyoma uterus. The symptoms are nonspecific, mostly abnormal uterine bleeding in perimenopausal women. Clinically and radiologically it is difficult to diagnose this entity. Histopathological examination and immunohistochemistry confirmed the diagnosis of LGESS. In addition of surgery chemotherapy, radiotherapy and immunotherapy treatments will be quite useful in all cases of LGESS. This case report of Low grade Endometrial stromal sarcoma (LGESS) is presented here because of its rarity.
ABSTRACT
Background: Abnormal uterine bleeding (AUB) is any heavy or unusual bleeding from the uterus (through your vagina). It can occur at any time during your monthly cycle, including during your normal menstrual period. Aim: This study aimed to compare the accuracy of TVUS and SIS in relation to hysteroscopy in assessing the uterine cavity and in detecting ER and PR in endometrium and their relation with endometrial polyps in women with peri and postmenopausal bleeding. Materials and methods: The present study was a prospective study which included 120 patients with AUB who were attending the department of gynaecology at Gandhi Medical College, Hyderabad from July 2012 to November 2015. Results: 120 patients were selected in this study. Patients suffering from endometrial polyp were 40 (33.34%), endometrial hyperplasia were 25 (20.83%), endometrial atrophy were 19 (15.83%), normal endometrium were 19 (15.83%) and submucous fibroid were 17 (14.17%). Age was shown in mean±SD and p-value was 0.39 and it was statistically non- significant. Parity was shown in mean±SD and p-value was 0.283 and it was statistically non-significant. SIS had 4 false negative results by missing 2 cases with endometrial polyps, 4 false positive result by diagnosing a case of 4 endometrial hyperplasia as polypi. SIS had 8 false negative results (by missing 6 cases), 8 false Katadi Venkata Sudha Madhuri, Kolati Srinivas Rao. Uterine Cavity Assessment and Endometrial Hormonal Receptors in Women with Peri and Post- Menopausal Bleeding. IAIM, 2018; 5(7): 38-44. Page 39 positive results (3 cases was found to have polypi and 5 cases were normal). Mean endometrial thickness in mm in various diagnosis by TVUS as follows; endometrial polyp had 15.49±10.98, endometrial hyperplasia had 8.19±5.55, endometrial atrophy had 4.55±2.97 and normal endometrium had 12.68±6.80. Conclusion: Especially with intra-cavitary lesions, sonohysterography is superior to ultrasound and very close to hysteroscopy. Hysteroscopy remains the reliable standard for uterine cavity assessment, but cannot replace the histopathology. In the pathogenesis of endometrial polyps and endometrial hyperplasia, the expression of endometrial steroid receptors is crucial.
ABSTRACT
Objective To investigate the influence of curettage of uterine cavity and hysteroscopy detection before operation on detection rate of abdominal cavity and the survival rate of patients with endometrial carcinoma. Methods 120 patients with endometrial carcinoma were chosen in the period from March 2011 to December 2013 were divided into 2 groups including curettage of uterine cavity group (64 patients) with curettage of uterine cavity and hysteroscopy group (56 patients) with hysteroscopy detection according to preoperative examinations methods; and the eligible rate of specimens, the concordance rate of pathological diagnosis, the detection rate of peritoneal cytology, the overall survival rate and progression free survival rate in 3 years with follow-up of both groups were compared. Results There was no significant difference in the eligible rate of specimens and the concordance rate of pathological diagnosis between the two groups (P > 0.05). The detection rate of ascites cytology of hysteroscopy group were significantly higher than curettage of uterine cavity group (P < 0.05). There was no significant difference in the overall survival rate and progression free survival rate in 3 years with follow-up between the two groups (P > 0.05). Conclusion Curettage of uterine cavity and hysteroscopy detection before operation on patients with endometrial carcinoma posses the same diagnosis value; And hysteroscopy detection maybe peritoneal metastasis risk, but have no effect on long-term survival and larger randomized controlled trials should be necessary.
ABSTRACT
Objective To investigate the influence of curettage of uterine cavity and hysteroscopy detection before operation on detection rate of abdominal cavity and the survival rate of patients with endometrial carcinoma. Methods 120 patients with endometrial carcinoma were chosen in the period from March 2011 to December 2013 were divided into 2 groups including curettage of uterine cavity group (64 patients) with curettage of uterine cavity and hysteroscopy group (56 patients) with hysteroscopy detection according to preoperative examinations methods; and the eligible rate of specimens, the concordance rate of pathological diagnosis, the detection rate of peritoneal cytology, the overall survival rate and progression free survival rate in 3 years with follow-up of both groups were compared. Results There was no significant difference in the eligible rate of specimens and the concordance rate of pathological diagnosis between the two groups (P > 0.05). The detection rate of ascites cytology of hysteroscopy group were significantly higher than curettage of uterine cavity group (P < 0.05). There was no significant difference in the overall survival rate and progression free survival rate in 3 years with follow-up between the two groups (P > 0.05). Conclusion Curettage of uterine cavity and hysteroscopy detection before operation on patients with endometrial carcinoma posses the same diagnosis value; And hysteroscopy detection maybe peritoneal metastasis risk, but have no effect on long-term survival and larger randomized controlled trials should be necessary.
ABSTRACT
Objective To investigate the Preventive effect of sodium hyaluronate gel on postoperative adhesion of hysteroscopic intrauterine adhesions. Methods 84 cases of IUA patients undergoing hysteroscopy were retrospectively selected,and divided into two groups according to the different ways of prevention and control of IUA,42 cases in each group.The control group was treated with Foley balloon catheter after operation,the study group was treated with sodium hyaluronate gel prevention on the based of control group.The clinical signs of the patients before and after treatment one,two and three months were observed,the therapeutic effects and complication were compared between two groups. Results After treatment one,two and three months,the adhesion type score and the score scale of study group, were significantly decreased,and lower than the control group,the difference was statistically significant (P<0.05).The total effective rate of the study group was 90.48%,which was significantly higher than that of the control group (83.33%),the difference was statistically significant (P<0.05).In the course of treatment,the complication rate of the two groups was 11.90% (5/42),there was no significant difference between the two groups in the incidence of complications. Conclusion Hyaluronic acid sodium gel on hysteroscopic intrauterine adhesions in patients with postoperative adhesions have a significant preventive effect,can improve the treatment efficiency and clinical signs,and with high security.
ABSTRACT
Objective:To observe the clinical curative effects of sequential therapy of estrogen and progesterone in the patient after second curettage with residual uterine cavity. Methods:Totally 60 patients after second curettage with residual uterine cavity were ran-domly divided into the treatment group (30 cases) and the control group (30 cases). The treatment group was treated by sequential therapy of estrogen and progesterone,while the control group was selected curettage and treated with Xinshenghua granules, and the treatment course was 21 days. The serum level ofβ-human chorionic gonadotropin (β-HCG) , stop time of vaginal bleeding, menstrual restore time and clinical curative effect were evaluated and compared between the two groups. Results:After the treatment, the serum level of β-HCG, stop time of vaginal bleeding and menstrual restore time in the treatment group were lower than those in the control group (P0. 05). Conclusion:The sequential therapy of estro-gen and progesterone can improve clinical symptoms and promote the functional recovery of uterus, which is worthy of clinical promo-tion.
ABSTRACT
Objective]To explore clinical experience in treating pregnancy uterine cavity effusion by tonifying kidney to remove blood stasis. [Method] With the study of TCM literature on pregnancy uterine cavity effusion, by combining with clinical practice, it expounds pathogenesis and treatment of syndrome differentiation of pregnancy uterine cavity effusion. [Result]The main pathogenesis of this disease focuses on kidney deficiency and blood stasis which can impair Chong and Ren channels,inducing insecurity of the fetal origin,so the clinical treatment principle centers on tonifying kidney to remove blood stasis,and the self-decoction that is the basic recipe may change with symptom, making the fetal origin secure. [Conclusion] Method of tonifying kidney to remove blood stasis is quite effective for pregnancy uterine cavity effusion in clinic,and it is worth further study.
ABSTRACT
Objective To evaluate uterine cavity of the patients who accept the treatment in vitro fertilization‐embryo trans‐fer(IVF‐ET)and determine the clinical value of hysteroscopy for the patients .Methods Between January 2012 and May 2014 ,539 cases who accepted the IVF‐ET and hysteroscopy ,were divided into two grops ,group A(258 patients examinated before IVF‐ET cycle) and group B(281 patients after the IVF‐ET failure) ,and retrospective analysis was performed for their uterine cavity and cervix canal data .Results The total incidence of abnormal hysteroscopic findings was 49 .54% ,and group B was significantly high‐er than that in group A(54 .10% vs .44 .57% ,χ2 =4 .5 ;P=0 .043) .The percent of abnormal cervix canal was 18 .74% ,and there wasn′t significant difference between the two groups .Conclusion The incidence of abnormal hysteroscopic findings in IVF‐ET is higher than that in normal patients ,so hysteroscopy has an important clinical value for diagnosis and evalution ,especially for pa‐tients with failure of IVF‐ET .
ABSTRACT
Objective To explore the clinical value of the disposable uterine cavity tissue suction tube in diagnosing abnormal u‐terine bleeding .Methods Seventy‐five patients ,who needed an endometrial biopsy because of abnormal uterine bleeding ,were se‐lected for this study .An endometrial biopsy was performed by a disposable uterine cavity tissue suction tube before the conventional suction dilatation and curettage (D&C) .The sample satisfactory rate and the diagnose accordance rate of the two methods were compared .Results The sample satisfactory rate of the disposable uterine cavity tissue suction tube and of the D&C was 85 .3%(64/75) and 94 .7% (71/75) respectively .The difference was not statistically significant(P>0 .05) .The diagnose accordance rate of the disposable uterine cavity tissue suction tube and the D&C was 90 .3% (56/62) and 93 .5% (58/62) respectively .The differ‐ence was not statistically significant(P>0 .05) .Conclusion To a certain extent ,endometrial biopsy performed by disposable uter‐ine cavity tissue suction tube can be a substitute for D&C as the initial inspection to assess abnormal uterine bleeding ,for its econo‐my ,efficiency and safety .
ABSTRACT
Objetivo: Demostrar que la revisión de la cavidad uterina instrumental gentil previene mayormente, la hemorragia posparto en comparación con la revisión manual de la cavidad uterina. Métodos: Estudio observacional, transversal, descriptivo y asociativo. Se llevó a cabo en las pacientes que ingresaron a las unidades toco-quirúrgicas de 2 hospitales públicos en el Estado de México. Muestreo por conveniencia (aquellas pacientes a quienes se les realizó revisión de cavidad uterina, durante la atención del parto). Muestra integrada por 236 pacientes. Resultados: Hubo 76 casos de hemorragia posparto, que se analizaron por grupos de edad, distinguiendo entre adolescentes, en edad reproductiva óptima y en edad materna avanzada, encontrándose mayor incidencia en el primer y tercer grupo, con el 34.4% y 48.3% de los casos, respectivamente. La relación entre hemorragia posparto y tipo de técnica de revisión de cavidad uterina, mostró mayor incidencia en la revisión manual. Los casos analizados según la instrucción del personal que brindó la atención, mostraron mayor número de casos de hemorragias, en quienes fueron atendidos por personal en formación. Los especialistas de Enfermería Perinatal, llevaron a cabo 97 procedimientos de atención de parto, 25 presentaron hemorragia posparto, frente a 72 que no presentaron la patología. Conclusiones: La revisión manual de cavidad uterina se asocia estrechamente con la aparición de hemorragia posparto, en contraste con la revisión instrumentada gentil, en la que se registró menor incidencia de esta complicación. La revisión de cavidad uterina debe practicarse bajo indicaciones precisas, hecho que contribuye a la disminución de complicaciones en el posparto.
Objective: to demonstrate that the gentle instrumental uterine cavity assessment largely prevents postpartum hemorrhage in comparison to the manual assessment. Methods: cross-sectional, observational, descriptive, and associative study on patients admitted to the labor-surgical units of two public hospitals in the State of México, using a convenience sample (patients to whom a uterine cavity assessment was performed during their labor process) of 236. Results: There were 76 total cases of post-partum hemorrhage. Patients were classified in three age groups: adolescents, optimal reproductive age, and advanced maternal age. Post-partum hemorrhage cases were prevalent in the first and third groups with 34.4% and 48.3% respectively. The manual uterine cavity assessment technique resulted in a higher prevalence of post-partum hemorrhage. More post-partum hemorrhage cases were also found in those patients attended by inexpert staff. Perinatal Nursing Specialists, conducted 97 childbirth care procedures, 25 had Postpartum Hemorrhage, compared to 72 who did not have the pathology. Conclusions: The manual uterine cavity assessment technique, is closely associated with the onset of Postpartum Hemorrhage, Gentle instrumented uterine cavity assessment resulted in a lower incidence of post-partum hemorrhage. In order to decrease post-partum complications, the uterine cavity assessment must be performed through precise procedures.
Subject(s)
Humans , Female , Pregnancy , Adolescent , AdultABSTRACT
Objective To study the correlative risk factors of uterine cavity adhesion (UCA),and observe the clinical efficacy of hysteroscope operation treatment of UCA.Methods According to whether the occurrence of UCA,120 patients with spontaneous abortion were divided into two groups.The correlative risk factors of UCA were analyzed by multiple factors regression analysis.The patients with UCA were treated with hysteroscope operation treatment,and the clinical efficacy were observed.Results In 120 patients with spontaneous abortion,46 patients (38.3％) had UCA.Single factor analysis result showed:UCA was correlated with pelvic inflammation,gravidity,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05),but UCA was not correlated with age,years of education,occupation,gestational weeks,menarche age (P＞ 0.05).Multiple factors analysis result showed:UCA was correlated with pelvic inflammation,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05).The total effective rates of hysteroscope operation treatment of mild,moderate and severe UCA were 100.0％ (18/18),93.8％ (15/16)and 83.3％ (10/12) respectively,there was no significant difference among them (P ＞ 0.05).Conclusions Along with the increasing of uterine cavity suction negative pressure and extension of uterine cavity suction time,the risk of UCA is also increasing,pelvic inflammation is also an independent risk factor of UCA.Hysteroscope operation treatment of UCA has better curative effect,especially for mild UCA,it is worth clinical application.
ABSTRACT
Objective To evaluate the combination influence of the factors such as the ways to putting into the water, addition with multienzyme and temperature of water on the cleaning effect of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. So that we can find out the best condition for cleaning, and provide the scientific evidence for the formulation of the norm of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. Methods According to the factorial design with triple pathogens, three factors were chosen to complete the ultrasonic cleaning of the curettage-aspiration device for uterine cavity, including the sequence of putting into water, addition with multienzyme or not and the temperature of cleaning. The cleaning effect was detected by adopting the eye-measurement or with the hemoglobin reagent. Results The sequence of putting into water first or next had little influence on ultrasonic cleaning;the effect of addition with multienzyme was more significant than without it;the effect of water temperature at 35 centi-degree or 40 centi-degree had no difference. Conclusions It had good benefits for the cleaning effect when the ultrasonic cleaning of the curettage-aspiration device for uterine cavity added multienzyme to the cleansing solution, while the sequence of putting into water first or next and the temperature of water at 35 centi-degree or 40centi-degree shows little influence on the cleaning effect.
ABSTRACT
OBJECTIVE To optimize the cleaning method of uterine cavity aspiration tube,compare with traditional method,in order to search the best way to improve the cleaning quality. METHODS Two groups A and B were set up according to the cleaning method and procedure. Group A (scrubbing group) was washed by optimized method,namely multi-enzyme soaking,scrubbing the lumen with special brush,rinsing with high pressure spray gun,and ultrasonic multi-enzyme cleaning. Group B (no scrubbing group) was used by traditional cleaning method;the cleaning procedure of Group B was almost the same with group A but had no lumen scrubbing. Both eyeballing and bacterial detection methods were used to compare cleaning quality of the two groups.RESULTS After cleaning procedure,the cleanliness pass rate of groups A and B was 99.52% and 56.25%,respectively (P
ABSTRACT
Demostrar que la migración de la burbuja de aire postransferencia embrionaria es un evento al azar que no depende de la posición del paciente. Estudio prospectivo multicéntrico. Se practicó transferencia embrionaria a 69 pacientes bajo guía ultrasonográfica. Se cargó el catéter de transferencia con una o dos burbujas junto con el medio conteniendo los embriones usando catéter de Frydman o catéter de Wallace y luego se les hizo seguimiento ecográfico en posición horizontal, 20-25 minutos más tarde y luego a los 90 minutos postransferencia en posición vertical para verificar movimiento y configuración de las burbujas. Centro Médico Docente La Trinidad, Caracas. Nortwestern University Feimberg School of medicine, Chicago, IL. EE.UU. En 50 (72,46 por ciento) de las pacientes se observó movimiento de las burbujas. En posición de pie se demostró una distribución al azar sin efecto visible de la gravedad. Las burbujas de aire se mueven y dividen frecuentemente posterior a la transferencia con la paciente en posición horizontal y de pie, lo que sugiere actividad contráctil uterina. No fue común observar movimiento de burbujas relacionada con la gravedad, lo que sugiere que el descanso horizontal postransferencia embrionaria puede ser innecesario.
To demonstrate that air bubble migration is a random event after embryo transfer regardless of the position of patient. Multicenter prospective study. Sixty nine embryo transfers were performed under ultrasound guidance. Transfer catheter was loaded with one or two air bubbles and medium containing embryos, either Wallace catheter or Frydman catheter were used, ultrasound tracking of air bubble was performed to verify movement and configuration inmediately, 20-25 minutes in horizontal position and 90 minutes on standing position after embryo transfer. Centro Medico Docente La Trinidad, Caracas. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Movement was observed in 50 (72,46 percent) of the patients. Movement was not observed related to gravity while standing up. Air bubbles move and split frequently after embryo transfer with the patient in the horizontal position and on standing, suggestive of active uterine contractions. Gravity related bubble motion was uncommon, suggesting that horizontal rest post embryo transfer may be unnecessary.
Subject(s)
Humans , Adult , Female , Ultrasonography , Embryonic Structures/transplantation , Hysteroscopy/methods , Embryo Transfer/methods , Uterus/transplantation , Gynecology , ObstetricsABSTRACT
There are several methods for diagnosing ovarian carcinoma, such as gynecological examination, ultrasonographic examination, and tumor marker examination. However, all these combinations have not yielded high specificity antl sensitivity results. For this reason, it is necessary to perform other examinations to enhance both specificity and sensitivity, and one of them which is of interest to be studied is cytological examination of uterine cavity. By cytological examination of uterine cavity, it is hope that malignant cells originating from ovarian malignant tumor can be found. Discovery of ovarian malignant cells is possible because of peristaltic mechanism in the fallopian tube and negative pressure from uterine cavity, that makes possible the transportation of ovarian malignant cells into uterine cavity through the tube. The objective of this study is to understand the sensitiviry and specificity of cytological examination of uterine cavity in detecting ovarian malignancy. This stucty was a diagnostic test with histological examination as the gold standard, to understand sensitivity, specificity, positive prediction value, and negative prediction value of cytological examination of uterine cavity. A total of 30 cases were included in the study. A nurnber of factors enhanced positive results in cytology of uterine cavity. Those factors were stage and ascites. The more advanced the stage, the greater the positive results, and the presence of ascites increased positive results. On diagnostic test, sensitivity of uterine cavity cytology was 48%, specificity 60, positive predictive value 85.7%, and negative predictive value 18.8% respectively. In conclusion, cytological examination of uterine cavity could be used as one of the methods in assistirtg the diagnosis of ovarian carcinoma.
Subject(s)
Brenner TumorABSTRACT
USB interface chip PDIUSBD12 and Microchip's single chip processor PIC16F877 are applied to achieving computerized multi-channel data acquisition, and then a detection system of multi-channel physiological parameters of uterine cavity is designed on the basis of the above-mentioned. Being plug-and-play, real-time and general-purpose, this system can meet the requirement of medical research on the relationship between these parameters and diseases of uterine cavity.