A 12-month comparative clinical investigation of a levonorgestrel-releasing intracervical device situated in the uterine cavity or cervical canal

Contraception ◽  
1996 ◽  
Vol 54 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Päivi Pakarinen ◽  
Tapani Luukkainen ◽  
Kaisa Elomaa ◽  
Kari Ratsula ◽  
Pekka Venesmaa ◽  
...  
Keyword(s):  
Clinical Investigation ◽  
Uterine Cavity ◽  
Cervical Canal

scholarly journals Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility

2017 ◽  
Vol 13 (4) ◽  
pp. 281-285 ◽  
Author(s):  
A. Nigam ◽  
P. Saxena ◽  
A. Mishra
Keyword(s):  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Diagnostic Modality ◽  
Infertile Patient ◽  
Infertile Women ◽  
Intrauterine Abnormalities

Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.Objective To detect uterine abnormalities in infertile women by various approaches i.e. HSG and hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy for the evaluation of tubo-uterine factor for primary infertility.Method One twenty eight infertile women were evaluated and HSG was performed as a basic test for evaluation of tubes and uterine cavity. Women were subjected to combined laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In absence of any HSG abnormality, women were subjected to ovulation induction for three to six months and if they did not conceive during this period they were undertaken for combined laparo-hysteroscopic evaluation.Result The positive predictive value of HSG for detecting the intrauterine abnormalities was 70% among 126 patients where the hysteroscopy could be performed successfully. The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative rate of 12.96%. The most frequent pathologies encountered by laparoscopy were tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06% infertile women had some abnormality on laparoscopy. This detection rate has been increased from 64.06% to 71.86% on including the concomitant hysteroscopy.Conclusion HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities in infertile patient. HSG and hysteroscopy are complementary to each other and whenever the patient is undertaken for diagnostic laparoscopy for the infertility, hysteroscopy should be combined to improve the detection rate of abnormalities especially in communities where there is enormous risk of pelvic infection.

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

scholarly journals Cervical gene delivery of the antimicrobial peptide, Human β-defensin (HBD)-3, in a mouse model of ascending infection-related preterm birth

2019 ◽  
Author(s):  
Natalie Suff ◽  
Rajvinder Karda ◽  
Juan Antinao Diaz ◽  
Joanne Ng ◽  
Julien Baruteau ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Uterine Cavity ◽  
Preterm Births ◽  
Premature Delivery ◽  
Cervical Canal ◽  
Adeno Associated Virus ◽  
Cellular Events ◽  
Microbial Invasion ◽  
Ascending Infection ◽  
Pregnant Mice

AbstractApproximately 40% of preterm births are preceded by microbial invasion of the intrauterine space: ascent from the vagina is the most common pathway. Within the cervical canal, antimicrobial peptides and proteins (AMPs) help to constitute a barrier which prevents ascending infection. We investigated whether expression of the AMP, human β-defensin-3 (HBD3), in the cervical mucosa prevented bacterial ascent from the vagina into the uterine cavity of pregnant mice. An adeno-associated virus vector containing both the HBD3 gene and GFP transgene (AAV8 HBD3.GFP) or control (AAV8 GFP), was administered intravaginally into E13.5 pregnant mice. Ascending infection was induced at E16.5 using bioluminescent E.coli (E.coli K1 A192PP-lux2). Bioluminescence imaging showed bacterial ascent into the uterine cavity, cellular events that led to premature delivery and a reduction in pups born alive, compared with uninfected controls. In addition, a significant reduction in uterine bioluminescence in the AAV8 HBD3.GFP-treated mice was observed 24 hours post-E.coli infection, compared to AAV8 GFP treated mice, signifying reduced bacterial ascent in AAV8 HBD3.GFP-treated mice. There was also an increase in the number of living pups in AAV HBD3.GFP-treated mice. We propose that HBD3 may be considered a possible candidate for augmenting cervical innate immunity to prevent ascending infection-related preterm birth.

VIII.—Transuterine (“Internal”) Migration of Fertilised Ova in the Albino Rat

1953 ◽  
Vol 65 (1) ◽  
pp. 106-116
Author(s):  
A. Young ◽  
George M. Wyburn
Keyword(s):  
Experimental Investigation ◽  
Internal Migration ◽  
Genital Tract ◽  
Uterine Cavity ◽  
Uterine Horn ◽  
The Other ◽  
Cervical Canal ◽  
Vascular Pattern ◽  
Albino Rat ◽  
In Pregnancy

SynopsisThe passage of ova down the Fallopian tube and uterine horn of one side into the horn of the other side is generally referred to as transuterine migration. There is evidence that such transmigration can occur in a wide variety of animals—Ungulata, Carnivora, Cheiroptera, Insectivora and Primates (Boyd, Hamilton and Hammond, 1944; Marshall'sPhysiology of Reproduction, 1952). In all these forms the genital tract has a single supravaginal segment varying from a common cervical canal to the single uterine cavity of the primate uterus simplex. The uterus of the albino rat is generally described as “uterus duplex”, with separate cervical canals opening independently into the vagina, and it has been stated by Hanson and Boone (1925, 1926) and by Slonaker (1927) that there is no evidence that transuterine migration occurs in the albino rat. In the course of an experimental investigation of the vascular pattern in pregnancy in the rat, some results were obtained which indicate that transuterine migration can occur in the albino rat.

Comparison Between 200 μg and 800 μg of Misoprostol for Cervical Ripening Prior to Operative Hysteroscopy: A Study Protocol for A Randomized Controlled Trial.

2020 ◽  
Author(s):  
Maria da Conceição Farias Souto Maior ◽  
Aurélio Antônio Ribeiro Costa ◽  
Alex Sandro Rolland Souza
Keyword(s):  
Study Protocol ◽  
Controlled Trial ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
University Teaching ◽  
Cervical Dilatation ◽  
Cervical Ripening ◽  
Teaching Hospitals ◽  
Cervical Canal ◽  
Operative Hysteroscopy

Abstract Background: Hysteroscopy, a minimally invasive procedure, has been increasingly used to treat disorders of the cervical canal and uterine cavity. However, difficulties related to the insertion of the hysteroscope through the cervical canal still remain. Although there are reported advantages in reducing cervical resistance with the use of misoprostol for cervical ripening, systematic reviews highlight the need to determine the optimal dose. This study was designed to compare two groups of patients submitted to cervical dilatation prior to operative hysteroscopy and pre-treated with either 200 µg or 800 µg of misoprostol for cervical ripening. Methods: A randomized, quadruple-blind clinical trial with patients submitted to cervical dilatation prior to operative hysteroscopy at university teaching hospitals in Recife, Pernambuco, Brazil. After the internal review boards of the participating institutes had approved the study protocol, data collection began on November 7, 2019, with expected completion on November 1, 2020. Patients included in the study following the informed consent process are randomly allocated to one of two groups, the first allocated to use 200 μg misoprostol and the second to use an 800-μg dose. In both groups, misoprostol will be administered vaginally 10-12 hours prior to operative hysteroscopy. The groups will be compared in relation to intraoperative and postoperative outcomes based on the following endpoints: baseline cervical dilatation, cervical length, degree of difficulty, duration of cervical dilatation, failure to dilate, adverse events and surgical complications. The chi-square test of association, Fisher's exact test and the Mann-Whitney test will be used to compare the groups, with an alpha error of <5% being considered significant. Discussion: The findings of this study will contribute towards establishing the optimal misoprostol dose for cervical ripening prior to operative hysteroscopy, ultimately facilitating hysteroscope insertion through the cervical canal. A gap will be filled in the currently available literature, providing future preoperative guidance. The 800-μg dose of misoprostol is expected to reduce resistance in the cervix and shorten the time until achieving cervical dilatation, delivering a less traumatic procedure for the patient. Therefore, the study is relevant for surgeons in this field, for the scientific community and, particularly, for patients. Trial registration: Clinical Trials Register: NCT04152317. Registered on November 5, 2019. URL https://clinicaltrials.gov/ct2/show/study/NCT04152317.

scholarly journals Risk Factors for Typical Endometrial Polypoid Adenomyoma

2021 ◽  
Author(s):  
Xinmei Wang ◽  
Hongyuan Zhang ◽  
Juan Xu ◽  
Pengpeng Qu
Keyword(s):  
Risk Factors ◽  
Menopausal Status ◽  
Uterine Cavity ◽  
Conservative Surgery ◽  
Cervical Canal ◽  
Rare Type ◽  
Normal Endometrium ◽  
Pathologic Features ◽  
Significant Difference ◽  
Independent Risk Factors

Abstract Objective: Typical endometrial polypoid adenomyoma (TPA) is a rare type of lesion in the uterine cavity or cervical canal. Although the clinical and pathologic features of TPA have been described extensively, reports on its pathogenesis and treatment remain inconclusive. This study was conducted to investigate the risk factors for endometrial TPA and recurrence and to further define the pathogenesis and treatment.Study design: This was a retrospective analysis of 488 cases of TPA and 500 cases of normal endometrium. Age, menopausal status, body mass index (BMI), reproductive history, and method of surgery were retrospectively analyzed. Among TPA cases, 360 were treated by conservative surgery. Risk factors for TPA and recurrence were assessed.Results: There was a significant difference in age, menopausal status, BMI, gravidity, and parity between the two groups (P<0.05). Age >50 years, menopause, obesity, gravidity >3, and parity >2 were risk factors for TPA (P<0.05). The incidence rate of endometriosis and adenomyosis in the TPA group was significantly higher than that in the normal endometrium group (P<0.05). Follow-up data (22–77 months) were obtained for 360 patients, revealing gravidity >3, menopause, curettage, and polyp clamp as independent risk factors for the recurrence of TPA (P<0.05). Conclusions: In addition to high estrogen levels, endometrial injury was the main contributor to TPA pathogenesis. Hysteroscopic electrotomy was the preferential treatment for TPA to avoid recurrence, especially for women with risk factors. Increasing the depth of ablation may prevent the recurrence of TPA more efficiently.

scholarly journals CERVICAL INSUFFICIENCY: ANAMNESIS, PREGNANCY AND CONSEQUENCES OF PREGNANCY (RETROSPECTIVE ANALYSIS)

2021 ◽  
pp. 30-38
Author(s):  
A. V. KAMINSKYI ◽  
O. I. ZHDANOVYCH ◽  
T. V. KOLOMIICHENKO ◽  
R. I. ISMAILOV ◽  
S. M. YANUTA
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
High Frequency ◽  
Premature Birth ◽  
Uterine Cavity ◽  
Lower Percentage ◽  
Control Group ◽  
Cervical Canal ◽  
Cervical Insufficiency

Cervical insufficiency (CI) remains one of the leading causes of miscarriage and premature birth. Purpose of the study: to determine the frequency of CI, the characteristics of the anamnesis, the course of pregnancy, childbirth, the state of the newborn and the identification of potential risk factors. Material and research methods. 8728 birth histories were analyzed, among which 166 (1.9%) stories of women whose pregnancy was complicated by CI were found. The main group consisted of 166 pregnant women with CI, the control group included 55 women without CI and other severe obstetric- gynecological and somatic pathologies. The results obtained and their discussion. The incidence of CI on average over 5 years was 1.9%. With CI, there is a significantly lower percentage of young women, and at the age of 35 and over - 27.1% of pregnant women versus 10.9% in the control group. Only one third (33.7%) of women with CI can be considered somatically healthy. The morbidity structure is dominated by endocrine pathology (30.7%), among which metabolic syndrome / obesity (19.9%) and diseases of the urinary excretory system (27.7%) are distinguished. High frequency of pathology of the cardiovascular system (21.1%) and autonomic dysfunction syndrome (25.9%), hepatobiliary pathology (15.1%), gastrointestinal diseases (19.3), allergic manifestations (16.9%). A third of patients (28.9%) have a combination of two or more somatic diseases. Every fourth woman has a history of an infectious pathology of the urinary excretory sphere (25.9). In 27.7% of patients - a combination of several infectious pathologies. Half of the patients (53.0%) had a complicated gynecological history: cervical ectopy (33.7%), chronic infectious diseases of the genital area (16.3%) and PCOS: (13.9%), synechiae of the uterine cavity (6.6 %) and congenital malformations of the genitals (3.0%). The combination of several gynecological pathologies was observed in 18.1% of women. Every fourth woman underwent an excision of the cervix (25.9%), 42.8% - intrauterine interventions with the expansion of the cervical canal, 59.2% of them two or more times. According to the obstetric anamnesis, spontaneous miscarriages and medical abortions in 27.7% and 33.7% of women, in 18.1% - a missed pregnancy, every fourth patient has premature birth (25.9%), and every 10th patient has suffered injuries cervix. With a current pregnancy, the threat of premature birth is most often noted (51.2%), in second place is an exacerbation of infection of the genitourinary sphere (41.0%) and the threat of premature birth (38.0%). High incidence of placental dysfunction (30.7%), gestational diabetes (13.9%), fetal growth retardation (12.0%) and preeclampsia (7.3%). Premature birth in 38.0% of cases, in 31.9% - premature rupture of membranes, delivery by cesarean section in 19.3% of cases. Noteworthy is the high frequency of intrauterine infection (13.9%). Conclusion. Based on the results of a retrospective analysis, after a more detailed assessment of possible risk factors for CI, the most informative ones will be identified and proposed for use in clinical practice.

COMPARATIVE ANALYSIS OF DIAGNOSTIC CRITERIA FOR ENDOMETRIAL HYPERPLASTIC PROCESSES

2021 ◽  
pp. 28-32
Author(s):  
N.S. Akulich ◽  
◽  
V.М. Savickaya ◽  
V.V. Dziadzichkina ◽  
◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Endometrial Cancer ◽  
Diagnostic Criteria ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Age Groups ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Morphological Examination ◽  
Gynecological Diseases

Endometrial hyperplastic processes are currently among the most common gynecological diseases, tend to a long, recurrent course, are characterized by the absence of specific, pathognomonic symptoms and the complexity of differential diagnosis. With a prolonged course without treatment, endometrial cancer develops in 25 % of cases against the background of benign endometrial changes. The diagnostic criteria allowing to refer the patient for separate diagnostic curettage are contradictory and not always reliable. The aim of this work was to study the informativeness of clinical data, indicators of ultrasound examination in the diagnosis of endometrial hyperplastic processes in different age periods, which is very important for identifying the most accurate methods for diagnosing this pathology. The current work analyzes the diagnostic criteria of endometrial hyperplasia and the results of histological examination of the endometrium in women of different age groups. A high percentage of discrepancy between clinical (47.8 % of cases) and ultrasound (60.4 % of cases) data with the results of patho- morphological examination in the perimenopausal period in the diagnosis of endometrial hyperplastic processes was established. The results obtained confirm the need for a differentiated approach to referral of patients, especially of perimenopausal age, to separate diagnostic curettage of the mucous membrane of the uterine cavity and cervical canal in case of suspected endometrial hyperplasia, taking into account complaints, the woman's age and ultrasound data.

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