Subject(s)
Meningomyelocele , Pregnancy , Female , Sheep , Animals , Humans , Meningomyelocele/surgery , Fetus/surgery , Prenatal CareABSTRACT
We report a case of splenic trauma during the third trimester of pregnancy that was successfully treated by arterial embolization with preservation of the spleen. This rarely reported management strategy during pregnancy had a favorable outcome. Such a strategy should be discussed and considered, taking into account maternal, obstetrical and fetal factors.
Subject(s)
Embolization, Therapeutic/methods , Spleen/injuries , Wounds, Nonpenetrating/therapy , Adult , Cesarean Section , Contrast Media , Female , Humans , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Third , Spleen/diagnostic imaging , Tomography, X-Ray Computed , Wounds, Nonpenetrating/diagnostic imagingABSTRACT
OBJECTIVES: There are no recommendations on the way emergency ultrasound should be performed but there are Standardized Acute Female Echography (SAFE) planes with quality criteria for ultrasound scoring. The objective of this study was to evaluate the impact of the quality of ultrasound on the diagnosis of ectopic pregnancy. METHODS: A retrospective study was conducted in 2016-2017 and included all Ectopic Pregnancies (EP). Clinical, biological and ultrasonographic characteristics were collected, in particular the analysis of ultrasound scans according to the scoring score of standardized planes (total score out of 15). EP diagnosed at first ultrasound and those from Pregnancy of unknown location (PUL) were compared. RESULTS: Hundred and seventeen patients were included: 45 (38.5%) in the group "EP from PLU" and 72 (61.5%) in the group "EP diagnosed directly". The ultrasound images were significantly better in the "directly diagnosed EP" group than in the "EP from PUL" group: 11.9/15 vs. 10.07/15 respectively (P=0.005). Moreover, in the group "EP from PUL", the images were significantly better on the final ultrasound diagnosing the EP compared to the first ultrasound performed: 11.4/15 vs. 10.07/17 (P=0.04). CONCLUSION: The evaluation of quality of ultrasound scan using a standardized scoring system shows an impact in the diagnosis of ectopic pregnancies.
Subject(s)
Endosonography , Pregnancy, Ectopic/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , Pregnancy , Pregnancy, Ectopic/therapy , Retrospective StudiesABSTRACT
According to numerous assisted reproductive medicine practitioners, semen with normal characteristics might not require further investigation. However, on the scale of the individual spermatozoon, it is well known that normal morphology does not guarantee optimal nuclear quality. Here, for 20 patients with normal sperm characteristics and a high proportion of spermatozoa with noncondensed chromatin, we subsequently assessed chromatin condensation status (aniline blue staining) and morphology (Papanicolaou staining) of the same 3749 spermatozoa. Although the overall proportion of morphologically normal spermatozoa was not correlated with the overall proportion of spermatozoa with noncondensed chromatin, an individual spermatozoon's morphology appeared to be closely related to its chromatin condensation status. Morphologically normal spermatozoa with noncondensed chromatin were seen in all patients; the proportion averaged 23.3% [min 10.9%-max 44.4%]. Morphologically abnormal spermatozoa were more likely to have noncondensed chromatin than morphologically normal ones (P < 0.0001). Small-, large- or multiple-headed spermatozoa presented the highest degree of noncondensation (>80% for each type), and more than half the vacuolated spermatozoa also presented noncondensed chromatin. However, a morphologically normal spermatozoon may also have a noncondensed chromatin.
