scholarly journals CASE REPORT OF TWO SUCCESSFUL PREGNANCY OUTCOMES AFTER RADICAL TRACHELECTOMY

2021 ◽  
Vol 20 (5) ◽  
pp. 179-183
Author(s):  
A. L. Chernyshova ◽  
L. A. Kоlomiets ◽  
V. I. Chernov ◽  
Y. M. Trushuk ◽  
D. V. Podolko ◽  
...  

Currently, the development and implementation of organ-preserving methods for patients of reproductive age are the treatment priorities in modern oncology. We report a case of two successful pregnancy outcomes in a 29-year-old patient with stage IB invasive cervical cancer, who underwent laparoscopic radical trachelectomy using high-tech diagnostic and treatment techniques. Alotech, an innovative radiopharmaceutical, and Rad Pointer laparoscopic gamma scanner were used for intraoperative detection of sentinel lymph nodes. In addition, a uterine obturator was formed during surgery using a titanium nickelide shape memory implant. This case showed the feasibility of preserving the uterus after delivery by caesarean section, with no evidence of tumor recurrence according to the findings of intraoperative morphological examination. 

2021 ◽  
Vol 67 (1) ◽  
pp. 85-90
Author(s):  
Alyena Chernyshova ◽  
Vitaly Аntipov ◽  
Larisa Коlomiets ◽  
Vladimir Chernov ◽  
Victor Gyunter ◽  
...  

The development and implementation of organ-preserving treatment modalities is the priority trend in the current cancer treatment of patients of the reproductive age. Methods of expanding indications for organ-preserving treatment in cancer patients are becoming relevant. We present our experience in performing radical trachelectomy with uterine transposition in patients with stage IB-II cervical cancer. Our surgical technique allows the preservation of the uterus and adnexa in patients with invasive cervical cancer, who need to receive combined modality treatment including extended surgery followed by chemotherapy or radiation therapy to the pelvis. Transposition of the uterus and adnexa after radical abdominal or laparoscopic trachelectomy allows the movement of the uterus and ovaries out of the radiation field. After completion of radiation therapy, the uterus with adnexa is repositioned into the pelvis and uterine-vaginal anastomosis is formed using an implant made of titanium nickelide. Independent pregnancy and the use of assisted reproductive technologies are permitted after passing the time when distant metastases are most likely to develop.  


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yuji Kamei ◽  
Ai Miyoshi ◽  
Nao Wakui ◽  
Takeya Hara ◽  
Serika Kanao ◽  
...  

Women in the reproductive age group diagnosed with cervical cancer can receive radical trachelectomy in case they wish to preserve fertility. However, the indication for this procedure in infertile women with cervical cancer is controversial depending on the underlying cause of infertility. Here, we present a case of a successful pregnancy following myomectomy accompanied with abdominal radical trachelectomy for an infertile woman with early cervical cancer. The patient was a 38-year-old nulliparous woman with a significant past medical history of infertility of unknown origin. She had been undergoing treatment with assisted reproductive technologies including artificial insemination and in vitro fertilization for over four years. During her treatment for infertility, she was diagnosed with stage IB1 cervical squamous cell carcinoma. She received abdominal radical trachelectomy and abdominal myomectomy in the same surgical procedure. Six months after the surgery, she went for the first embryo transfer and became pregnant. At 26 weeks of pregnancy, a male baby weighing 980 g was delivered with an Apgar score of 3/5/7 by cesarean section due to chorioamnionitis. The baby has received general care in a neonatal intensive care unit for four months and weighed 4520 g when discharged.


2019 ◽  
Vol 65 (5) ◽  
pp. 715-720
Author(s):  
Alena Chernyshova ◽  
Larisa Kolomiets ◽  
Viktor Gyunter ◽  
Yekaterina Marchenko

The article summarizes and presents 10 years of experience in the organ-preserving treatment of invasive cervical cancer in patients of reproductive age in the amount of radical trachelectomy. The study included 68 patients with cervical cancer (T1a1NxM0 - T2aNxM0), the average age was 34.1 ± 8.4 years. Of these, 39 patients underwent radical trachelectomy with transabdominal access, 29 - with laparoscopic. During the operation, a mesh implant with a shape memory, woven into a stocking of super-elastic nickel-titanium filament with subsequent fixation with separate sutures along the perimeter, was used to form the locking apparatus of the uterus and strengthen the utero-vaginal anastomosis. It has been shown to be highly effective for providing a “locking” effect of the cervix. Of all the patients treated, 15 (22%) spontaneous pregnancies were registered, 9 after PAT and 6 after RT with laparoscopic access, of which 3 had operative delivery in terms of 29, 31 and 38 weeks. One currently has a prolongation of pregnancy (33 weeks), 2 (13.3%) had spontaneous miscarriages, the rest interrupted the pregnancy for various reasons. The onset of pregnancy was noted in patients after laparoscopic RT within a shorter period after surgery from 3 to 18 months. Menstrual dysfunction after surgery was observed in 4% and 19%, respectively. Dysfunctional uterine bleeding prevailed. The median follow-up was 69 months; 1 relapse was detected (1.4%). Overall survival rate of 100%.


2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Vladimir Sergeevich Gordeev ◽  
◽  
Joseph Akuze ◽  
Angela Baschieri ◽  
Sanne M. Thysen ◽  
...  

Abstract Background Paradata are (timestamped) records tracking the process of (electronic) data collection. We analysed paradata from a large household survey of questions capturing pregnancy outcomes to assess performance (timing and correction processes). We examined how paradata can be used to inform and improve questionnaire design and survey implementation in nationally representative household surveys, the major source for maternal and newborn health data worldwide. Methods The EN-INDEPTH cross-sectional population-based survey of women of reproductive age in five Health and Demographic Surveillance System sites (in Bangladesh, Guinea-Bissau, Ethiopia, Ghana, and Uganda) randomly compared two modules to capture pregnancy outcomes: full pregnancy history (FPH) and the standard DHS-7 full birth history (FBH+). We used paradata related to answers recorded on tablets using the Survey Solutions platform. We evaluated the difference in paradata entries between the two reproductive modules and assessed which question characteristics (type, nature, structure) affect answer correction rates, using regression analyses. We also proposed and tested a new classification of answer correction types. Results We analysed 3.6 million timestamped entries from 65,768 interviews. 83.7% of all interviews had at least one corrected answer to a question. Of 3.3 million analysed questions, 7.5% had at least one correction. Among corrected questions, the median number of corrections was one, regardless of question characteristics. We classified answer corrections into eight types (no correction, impulsive, flat (simple), zigzag, flat zigzag, missing after correction, missing after flat (zigzag) correction, missing/incomplete). 84.6% of all corrections were judged not to be problematic with a flat (simple) mistake correction. Question characteristics were important predictors of probability to make answer corrections, even after adjusting for respondent’s characteristics and location, with interviewer clustering accounted as a fixed effect. Answer correction patterns and types were similar between FPH and FBH+, as well as the overall response duration. Avoiding corrections has the potential to reduce interview duration and reproductive module completion by 0.4 min. Conclusions The use of questionnaire paradata has the potential to improve measurement and the resultant quality of electronic data. Identifying sections or specific questions with multiple corrections sheds light on typically hidden challenges in the survey’s content, process, and administration, allowing for earlier real-time intervention (e.g.,, questionnaire content revision or additional staff training). Given the size and complexity of paradata, additional time, data management, and programming skills are required to realise its potential.


2016 ◽  
Vol 26 (1) ◽  
pp. 163-168 ◽  
Author(s):  
Yoshifumi Kasuga ◽  
Hiroshi Nishio ◽  
Kei Miyakoshi ◽  
Suguru Sato ◽  
Juri Sugiyama ◽  
...  

2002 ◽  
Vol 23 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Mahshid Ahrari ◽  
Attallah Kuttab ◽  
Samir Khamis ◽  
Amal Ali Farahat ◽  
Gary L. Darmstadt ◽  
...  

2020 ◽  
Vol 319 (3) ◽  
pp. E557-E561 ◽  
Author(s):  
Henry C. Ezechukwu ◽  
Cornelius A. Diya ◽  
Nirajan Shrestha ◽  
Deanne H. Hryciw

The endocannabinoid system (ECS) is associated with several physiological processes, including reproduction. This system consists of the cannabinoid receptors, endocannabinoid ligands, and enzymes that metabolize and degrade these fatty acids. Recent evidence shows that cannabinoid receptors are expressed in cells of the reproductive system, including endometrial stromal cells, ovaries, and sperm cells. Emerging and recent research suggests that the ECS may play a significant role in reproduction. The endocannabinoid ligands anandamide and 2-arachidonoylglycerol are crucial for successful endometrium decidualization, placental development, and embryo implantation. Alteration in cannabinoid receptor expression or in endocannabinoid homeostasis by excessive intake of cannabis during pregnancy is associated with negative pregnancy outcomes, including preterm birth. The use of medicinal cannabis is becoming more widespread in Western countries, especially in people of reproductive age. Cannabis contains phytocannabinoids, which modulate the ECS, and emerging evidence suggests that phytocannabinoids, through their action on cannabinoid receptors, may have a negative impact on fertility, pregnancy outcome, and fetal health. In this mini-review, we highlight the recent advances in the field, which explore the role of endocannabinoids in early pregnancy and the effects of excessive intake of phytocannabinoids in pregnancy outcomes.


2008 ◽  
Vol 111 (3) ◽  
pp. 555-560 ◽  
Author(s):  
Rene Pareja F. ◽  
Pedro T. Ramirez ◽  
Mauricio Borrero F. ◽  
Gonzalo Angel C.

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