scholarly journals Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications

2020 ◽  
pp. 1-12
Author(s):  
Martina Chalupska ◽  
Marian Kacerovsky ◽  
Jaroslav Stranik ◽  
Miroslav Gregor ◽  
Jan Maly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Molecular Biology ◽  
University Hospital ◽  
Fetal Membranes ◽  
Obstetrics And Gynecology ◽  
Clinical Implications ◽  
Cervical Insufficiency ◽  
Amniotic Cavity ◽  
Microbial Invasion ◽  
Gestational Age At Delivery

<b><i>Introduction:</i></b> The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insufficiency with prolapsed fetal membranes. <b><i>Methods of Study:</i></b> This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. <b><i>Results:</i></b> In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both <i>p</i> &#x3c; 0.0001), and lower gestational age at delivery (<i>p</i> &#x3c; 0.0001 and <i>p</i> = 0.004) and percentiles of birth/abortion weight (<i>p</i> = 0.03 and <i>p</i> = 0.009, respectively) than in those without intra-amniotic inflammation. <b><i>Conclusions:</i></b> Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes.

Interleukin 16 in pregnancy, parturition, rupture of fetal membranes, and microbial invasion of the amniotic cavity

2000 ◽  
Vol 182 (1) ◽  
pp. 135-141 ◽  
Author(s):  
Neil Athayde ◽  
Roberto Romero ◽  
Eli Maymon ◽  
Ricardo Gomez ◽  
Percy Pacora ◽  
...  
Keyword(s):  
Fetal Membranes ◽  
Amniotic Cavity ◽  
Microbial Invasion ◽  
In Pregnancy

scholarly journals Adjunctive Pessary Therapy after Emergency Cervical Cerclage for Cervical Insufficiency with Protruding Fetal Membranes in the Second Trimester of Pregnancy: A Novel Modification of Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Katarzyna Kosinska-Kaczynska ◽  
Dorota Bomba-Opon ◽  
Aleksandra Zygula ◽  
Bartosz Kaczynski ◽  
Piotr Wegrzyn ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Fetal Membranes ◽  
Control Group ◽  
Study Group ◽  
Cervical Insufficiency ◽  
Cervical Cerclage ◽  
Hospitalization Rates ◽  
Gestational Age At Delivery ◽  
The Mean ◽  
Medical University

Aim. To evaluate the effectiveness of adjunctive pessary therapy after emergency cervical cerclage (ECC) in improving perinatal outcome in cervical insufficiency with fetal membranes protruding into the vagina.Material and Methods. A retrospective analysis of patients treated at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2008 and 2013. The study group consisted of 15 women treated with ECC and a pessary and the control group consisted of 17 patients treated with cerclage only.Results. The mean gestational age at delivery was significantly higher in the study group (34.7 versus 29.7 weeks,p=0.03). The period between cerclage insertion and delivery was significantly longer in the study group (82.9 versus 52.1 days,p=0.045). The mean neonatal birthweight and neonatal “discharge alive” ratio were higher in the study group, although not statistically significant (2550 g versus 1883 g,p=0.14, and 93.3% versus 70.5%,p=0.18, resp.). NICU hospitalization rates were comparable (33.3% versus 35.3%,p=0.9).Conclusions. Adjunctive pessary therapy allows delaying delivery in women treated with ECC due to cervical insufficiency with protruding fetal membranes. It also seems to improve neonatal outcome, although the differences are not statistically significant. Further prospective study is required to prove these findings.

Hysteroscopy in the Clinic: Application of Clinical Pathway

2020 ◽  
Vol 16 (1) ◽  
pp. 69-73
Author(s):  
María Dolores Lara Domínguez ◽  
Carlota García-Salmones González ◽  
Elena Mantrana Bermejo ◽  
Virginia Caballero Fernández ◽  
María Rosa Oña López
Keyword(s):  
Retrospective Study ◽  
Operating Room ◽  
Clinical Pathway ◽  
Local Anaesthesia ◽  
Effective Procedure ◽  
University Hospital ◽  
Obstetrics And Gynecology ◽  
Operative Hysteroscopy

Background:: A retrospective study that analysed data for three consecutive years from the Hysteroscopy Clinic at the Department of Obstetrics and Gynecology, Valme University Hospital. Objective:: To analyse the data of lesions removed in the hysteroscopy clinic in comparison with those scheduled for the operating room to show that hysteroscopy could be a more effective procedure. Method:: Patients undergoing operative hysteroscopy for various indications were included. The 5 mm Bettocchi hysteroscopes and the 5.8 mm Palex Mini-Resectoscope were used. Results:: A total of 1233 patients were seen in the hysteroscopy clinic between 2015 and 2017. In 2015, 344 hysteroscopies were performed, of which 57 (16.5%) were performed in the operating room. In 2016, 445 hysteroscopies were performed and 46 (10.3%) were scheduled in the operating room. During 2017, a total of 444 hysteroscopies were performed, of which only 6 (1.3%) were performed in the operating room (P < 0.001). Five large fibroids and one case of complex polyp were removed in the operating room in 2017. The mini-resector was used in 202 cases (45.4%). Paracervical local anaesthesia was given to 383 (86.2%) patients. Conclusion:: The data obtained in our study shows a significant reduction in the number of hysteroscopies scheduled for surgery in 2017 (1.3%) and, therefore, hysteroscopy has been shown to be a more effective procedure. This trend may be due to the introduction of the mini-resectoscope and the use of paracervical local anaesthesia.

scholarly journals COVID-19 does not stop obstetrics: what we need to change to go on safely birthing. The experience of a University Obstetrics and Gynecology Department in Milan

2020 ◽  
Vol 48 (9) ◽  
pp. 997-1000
Author(s):  
Nikita Alfieri ◽  
Stefano Manodoro ◽  
Anna Maria Marconi
Keyword(s):  
Health System ◽  
University Hospital ◽  
Obstetrics And Gynecology ◽  
Daily Routine ◽  
Clinical Services ◽  
Wuhan City ◽  
Set Up

AbstractSince SARS-COV-2 appeared in Wuhan City, China and rapidly spread throughout Europe, a real revolution occurred in the daily routine and in the organization of the entire health system. While non-urgent clinical services have been reduced as far as possible, all kind of specialists turned into COVID-19 specialists. Obstetric assistance cannot be suspended and, at the same time, safety must be guaranteed. In addition, as COVID-19 positive pregnant patients require additional care, some of the clinical habits need to be changed to face emerging needs for a vulnerable but unstoppable kind of patients. We report the management set up in an Obstetrics and Gynecology Unit during the COVID-19 era in a University Hospital in Milan, Italy.

Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients

2001 ◽  
Vol 115 (2) ◽  
pp. 112-118 ◽  
Author(s):  
A. Escribano Uzcudun ◽  
P. Bravo Fernández ◽  
J. J. Sánchez ◽  
A. García Grande ◽  
I. Rabanal Retolaza ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Clinical Features ◽  
Medical Records ◽  
Performance Status ◽  
Nasopharyngeal Cancer ◽  
University Hospital ◽  
Premalignant Lesions ◽  
Pharyngeal Cancer ◽  
Presenting Symptoms

Pharyngeal cancer still presents an unsatisfactory mortality (30-40 per cent in most series, with a slightly better prognosis for nasopharyngeal cancer relative to both oropharyngeal and hypophyarngeal cancers) despite advances in treatment. Therefore, it is critical to know the clinical features of pharyngeal cancer. The purpose of this study was to investigate the most relevant clinical features of pharyngeal cancer (oropharyngeal, hypopharyngeal, and nasopharyngeal) in order to improve knowledge of this malignancy with the aim of ameliorating diagnosis and treatment.The retrospective study was based on a review of medical records from 258 consecutive patients with pharyngeal cancer (oropharyngeal, hypopharyngeal and nasopharyngeal) diagnosed at La Paz University Hospital, Madrid, Spain, between January 1 1991 and and December 31 1995. Medical records were provided by the Departments of Otorhinolaryngology, Head and Neck Surgery, Radiation Oncology, and Medical Oncology.All medical records were analysed for the following clinical variables: 1) incidence, 2) sociodemographics, 3) sites (oropharynx, hypopharynx, nasopharynx) and subsites, 4) clinical and histological staging, 5) pathlogy, 6) presenting symptoms, 7) time to diagnosis, 8) patients’ general performance status at diagnosis, 9) personal cancer history and synchronous head and neck tumours, 10) premalignant lesions, and 11) paediatric cases.Our most outstanding finding was the excessively long time that elapsed between first clinical manifestation appearance and conclusive diagnosis of pharyngeal cancer (4.7 months for pharynx, 4.5 for oropharynx, 4.4 for hypopharynx and 6.5 for nasopharynx cancers). It was found that nasopharyngeal cancer was quite different from both oropharyngeal and hypopharyngeal cancers with respect to its potential aetiology, risk factors and clinical presentation. In addition it has a better prognosis.

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