Retroperitoneal Dissection: Techniques to Locate Uterine Arteries at the Origin

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

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Structural changes in uterine tissues after uterine artery embolization in patients with leiomyoma complicated by uterine bleeding

GYNECOLOGY ◽

10.26442/2079-5696_20.1.78-82 ◽

2018 ◽

Vol 20 (1) ◽

pp. 78-82

Author(s):

G P Titova ◽

M M Damirov ◽

L S Kokov ◽

O N Oleynikova ◽

G E Belozerov

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Structural Changes ◽

Morphological Changes ◽

Uterine Bleeding ◽

Small Scale ◽

Artery Embolization ◽

Vessel Occlusion ◽

Uterine Arteries ◽

Uterine Tumors

Uterine leiomyoma (UL) is often complicated by the development of uterine bleeding. In urgent gynecology for the implementation of endovascular hemostasis, uterine artery embolization (UAE) is used. Performing UAE allows to stop and/or significantly reduce the intensity of bleeding and prepare a patient for surgical intervention. At the same time, the morphological changes that occur in uterine tissues in operated UL patients after performing the UAE are not studied. The aim was to study the peculiarities of pathomorphological changes in uterine tumors and tissues in operated UL patients complicated by uterine bleeding after performing UAE. Material and methods. The results of morphological changes appearing in tumors and tissues of the uterus in 39 operated UL patients, who were used for stopping uterine bleeding, were analyzed. Results. After applying different types of embolizing agents in macroscopic study of the uterus, signs of ischemia of its tissues were revealed, and the most pronounced disorders were detected in the UL nodes. Morphologically it was established that UAE microemboli resulted in vessel occlusion with increasing thrombosis in their distal sections. UAE was not accompanied by occlusal occlusion of the arteries and resulted in small-scale necrosis of the tumor with complete regeneration of the endometrium. Conclusions. The results of the morphological study showed that after the UAE was performed, the myomatous nodes underwent dystrophic, necrobiotic and necrotic changes. Depending on the nature of occlusion of the uterine arteries, various variants of necrosis (scale and completeness of the process) developed in the tumor tissue, which was aseptic in nature.

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USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.4_5.1 ◽

2014 ◽

pp. 9-18

Author(s):

Thi Linh Giang Truong ◽

Vu Quoc Huy Nguyen

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Umbilical Artery ◽

Functional Method ◽

Invasive Technique ◽

Routine Practice ◽

Fetal Health ◽

Uterine Arteries ◽

Non Invasive ◽

Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

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Variant origin of Common Interosseous Artery from Brachial Artery

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8245 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Pralhad D. Subbannavar

Keyword(s):

Brachial Artery ◽

The Body ◽

Dead Body ◽

Invasive Procedures ◽

Arterial Variations ◽

Statistical Inferences ◽

Individual Variations ◽

Interosseous Artery ◽

Cubital Fossa ◽

Dissection Techniques

Acharya Sushruta has emphasized the method and importance of dissection to study anatomy practically. Perfect knowledge of anatomy is vital for practicing surgeons and hence the training of dissecting the dead body was considered as mandatory for surgeons. Though dissection techniques may give the perception of the structure of organs, the pervading and subtle consciousness in the body can be experienced with the eyes of knowledge and penance only. Though the standard anatomy is defined based on statistical inferences on comparing large number of subjects, individual variations and exceptional structural specialties tend to occur quite frequently. Proper recording and publication of such instances would strengthen the knowledge base of the science. Knowledge regarding arterial variations of upper limb is important for surgeons and orthopedicians as they are commonly involved in invasive procedures. We report a case ofvariant origin of right common interosseous artery from brachial artery in cubital fossa. It followed a normal course after the origin.

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Small bowel obstruction due to retroperitoneal hernia following renal transplant: a case report

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa467 ◽

2020 ◽

Vol 2020 (11) ◽

Author(s):

Atta Nawabi ◽

Adam C Kahle ◽

Clay D King ◽

Perwaiz Nawabi

Keyword(s):

Computed Tomography ◽

Case Report ◽

Renal Transplantation ◽

Renal Transplant ◽

Common Type ◽

Postoperative Phase ◽

Oral Contrast ◽

Large Defect ◽

Retroperitoneal Dissection ◽

Unclear Etiology

Abstract Para duodenal hernias, the most common type of retroperitoneal hernias, are thought to occur naturally from abnormal gut rotation because of fusion folds within the peritoneum. Retroperitoneal hernias are a rare postoperative complication and have not been described after renal transplantation via a retroperitoneal approach. This case report presents a 48-year-old male with intestinal obstruction after renal transplant due to herniation into the retroperitoneum via an incidentally created peritoneal defect. We suggest computed tomography with oral contrast be used in the early postoperative phase to assess for obstruction in patients with prolonged ileus of unclear etiology who have undergone retroperitoneal dissection. Small peritoneal defects should be closed during dissection. Larger, or multiple peritoneal defects should be extended to make a single, large defect to decrease the possibility of bowel herniating and becoming incarcerated.

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