scholarly journals Significance of hysteroscopy in diagnosis and treatment of congenital uterine anomalies

2020 ◽  
Vol 77 (11) ◽  
pp. 1161-1168
Author(s):  
Milena Saranovic ◽  
Suzana Matejic ◽  
Nebojsa Matejic ◽  
Ivan Radic ◽  
Goran Trajkovic
Keyword(s):  
Congenital Anomalies ◽  
Statistical Significance ◽  
Uterine Cavity ◽  
Diagnosis And Treatment ◽  
Uterine Anomalies ◽  
Term Delivery ◽  
Reasonable Suspicion ◽  
Uterine Septum ◽  
Uterus Bicornis ◽  
And Function

Background/Aim. Hysteroscopy is one of the important methods in the endoscopic diagnosis and treatment of infertility, particularly at the examination of the morphology and function of the uterus. Uterine factor is present at 10% of infertile women, in which changes of the uterus can be congenital or acquired. The aim of this study was to estimate the significance of hysteroscopy in the diagnosis and treatment of congenital anomalies of the uterine cavity in patients in whom there was a reasonable suspicion for them based on prior clinical, ultrasound and hysterosalpingography (HSG) findings. The significance of hysteroscopy is considered in relation to the number of pregnancies achieved depending on the malformations in the 12 months period after the completion of the diagnostic or operational hysteroscopy. Methods. The study included 176 patients with congenital uterine anomalies, which had undergone hysteroscopy, diagnostic or operative, in the period from January 1, 2013 till January 1, 2016. Percentage of pregnancy was followed at all patients during the first 12 months after surgery. Patients were divided into two groups: the first group contained women who had pregnancy, and the second group included women who earlier were not pregnant. Their characteristics were compared, such as: age, duration of infertility, previous pregnancy and/or pregnancy loss, HSG and ultrasound findings, types of congenital anomalies, type of hysteroscopy, as well as the existence of associated pathology. Results. The mean age of patients tested in the study was 35 years. The group of patients with primary infertility had a total of 107 patients, while 69 patients were with secondary infertility. The average duration of infertility was 3 years in the studied patients. In the 12-months period, 39 of the examined women began pregnancy, which was completed with term delivery in 33 women. ?2 test showed a statistical significance difference (p < 0.05) between the groups of the patients with or without pregnancy after hysteroscopy in relation to infertility types as well as in relation to the number of previous miscarriages. Conclusion. Subseptus and septus uteri were the most common congenital uterine malformations in our patients. Very rare were uterus arquatus, uterus unicornis and uterus bicornis. In our study, 1/5 of examined women achieved pregnancy after hysteroscopy in the reporting period of 12 months, while the majority of these pregnancies ended with term delivery. The percentage of miscarriages in the examined women was reduced from 38% to 15% after hysteroscopy. In women who achieved pregnancy, uterine septum and subseptum were mostly diagnosed and in these patients hysteroscopic resection was successfully performed.

scholarly journals The importance of operative hysteroscopy in treating pathologies of the uterine cavity in infertile patients

2021 ◽  
Vol 46 (2) ◽  
pp. 72-78
Author(s):  
Aleksandar Dević ◽  
Ana Dević ◽  
Mladenko Vasiljević ◽  
Goran Zajić
Keyword(s):  
Congenital Anomalies ◽  
Uterine Cavity ◽  
World Health ◽  
Type I ◽  
Pathological Changes ◽  
Operative Hysteroscopy ◽  
Minimally Invasive Surgical Procedure ◽  
Minimally Invasive Surgical ◽  
Uterine Anomalies ◽  
Infertile Patients

According to the definition of the World Health Organization (WHO), infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. One of the causes of sterility is inborn and acquired uterine anomalies. The best visualization of the inside of the uterus is achieved hysterscopically. Hysteroscopy is a minimally invasive surgical procedure and has the greatest significance in the diagnosis and treatment of congenital anomalies of the uterus. It is possible to eliminate and correct most of the congenital anomalies of the uterus, and it also enables the removal of other pathological changes in the cavity of the uterus. The incidence of congenital uterine anomalies in general population is 0.1-3.5%. Infertile patients have a higher incidence of these anomalies which range from 3-6%, and 5-10% in habitual abortions. The study included 200 infertile patients up to 40 years of age, with performed surgical hysteroscopy due to diagnosed changes in the uterine cavity. The patients were operated at the Department of infertility of the Obstetrics and Gynecology Clinic "Narodni Front" in Belgrade, in 2013. and 2014. The following pathological changes of the uterine cavity, were hysteroscopically removed: submucosal fibroids type 0 and type I. The aim of this paper was to evaluate the success of operative hysteroscopy in the treatment of pathological changes of the uterine cavity in infertile patients, based on the number of relapses in the first six months upon surgery. Relapses occurred in 0.5% of patients during a six-month postoperative course. Complications during hysteroscopic operations were intraoperative and postoperative. There were 1.5% of overall complications in the participants.

scholarly journals A méhüreg anatómiai rendellenességei habituális vetélőkben

2015 ◽  
Vol 156 (27) ◽  
pp. 1081-1084 ◽  
Author(s):  
Ádám Galamb ◽  
Boglárka Pethő ◽  
Dávid Fekete ◽  
Győző Petrányi ◽  
Attila Pajor
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Uterine Cavity ◽  
Endometrial Polyp ◽  
3 Dimensional ◽  
Uterine Anomalies ◽  
Uterine Septum

Introduction: One percent of couples trying to have children are affected by recurrent miscarriage. These pregnancy losses have different pathogenetic (genetic, endocrine, anatomic, immunologic, microbiologic, haematologic and andrologic) backgrounds, but recurrent miscarriage remains unexplained in more than half of the affected couples. Aim: To explore risk factors for recurrent pregnancy loss the authors studied the incidence of anatomic disorders of the uterine cavity occur in Hungarian women with recurrent miscarriage. Method: Medical records of 152 patients with recurrent miscarriage were analyzed retrospectively. In order to explore disorders of the uterine cavity hysteroscopy or 3-dimensional sonography in 132 women, hysterosalpingography in 16 and hysterosalpingo-sonography in 4 patients were used. Results: Incidence of anomalies in the uterine cavity was found in women with recurrent miscarriage to be 15.8%. A variety of the uterine anomalies was found including uterine septum in 6.5%, endometrial polyp in 2.6%, arcuate and bicornuate uteri both in 2% and 2%, submucosal myoma in 1.3 %, and intrauterine synechiae in 1.3%. Conclusions: These findings suggest that morphologic disorder of the uterine cavity is frequent in Hungarian women with recurrent miscarriage. Therefore, assessment of the uterine anatomy is recommended in such patients. Orv. Hetil., 2015, 156(27), 1081–1084.

scholarly journals Uterine leiomyoma: modern aspects of clinic, diagnosis and treatment

2021 ◽  
Vol 5 ◽  
pp. 7-18
Author(s):  
О.V. Golyanovskiy ◽  
O.Yu. Kachur ◽  
M.А. Budchenko ◽  
K.V. Supruniuk ◽  
S.V. Frolov
Keyword(s):  
Magnetic Resonance ◽  
Uterine Leiomyoma ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Diagnosis And Treatment ◽  
Scientific Publications ◽  
Genetic Components ◽  
Gynecology And Obstetrics ◽  
Gynecological Examination

According to the WHO, neoplastic processes of the uterus remain one of the important and relevant areas of modern gynecology. Uterine leiomyoma is one of the most common tumors of the female reproductive system. According to the latest data, every 4–5th woman in the world is diagnosed with leiomyoma, the incidence of which under the age of 35 reaches 50%, and according to autopsy data reaches 80%.The article provides a review of the scientific publications in recent years devoted to the study of the problem of uterine fibroids – relevance, causes and mechanisms of development, provides a classification, clinical manifestations, modern diagnostics and management tactics.The etiological factors of leiomyoma are numerous, there is no a single theory of the disease. Among the pathogenetic factors of leiomyoma are hormonal disorders, genetic components, infections, injuries. There are several classifications of leiomyoma, the most common classification was proposed by the International Federation of Gynecology and Obstetrics, which reflects the types of leiomatous nodes depending on their location and relationship to the uterine cavity and myometrium.Clinical manifestations of uterine fibroids range from asymptomatic to painful sighns and hemorrhagic syndromes, symptoms of compression of adjacent organs, the development of uterine bleeding, which lead to severe anemia. The nature of clinical features significantly depend on the localization of the leiomyoma nodes in the uterine body and their relationship to the uterine cavity (submucosal, intramural, subserous), as well as their number, size and blood supply.Modern diagnosis of leiomyoma is based on anamnesis, bimanual gynecological examination, ultrasound examination, and in some cases – magnetic resonance imaging and computed tomography examinations, hysteroscopy and laparoscopy. Today, the main methods of treatment of leiomyoma are conservative, surgical and radiological methods (uterine artery embolization, magnetic resonance-guided focused ultrasound).In addition to the listed modern aspects of the clinic, diagnosis and treatment of uterine leiomyoma, the article emphasizes the importance of preventive measures to reduce the incidence of this gynecological pathology.

Study of the Vascularity of Uterine Septum Using Three Dimensional Power Doppler Ultrasound

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I M Amer ◽  
N E Hassan ◽  
M E Ahmed ◽  
H M M Elnaggar
Keyword(s):  
Doppler Ultrasound ◽  
Power Doppler ◽  
Adhesion Formation ◽  
Recurrent Abortion ◽  
Power Doppler Ultrasound ◽  
Septate Uterus ◽  
3D Power Doppler ◽  
Uterine Anomalies ◽  
Significant Difference ◽  
Uterine Septum

Abstract Background Uterine anomalies are a relatively common congenital abnormality, with uterine septum being the most common. This is even truer in patients with recurrent pregnancy loss, in whom rates of uterine abnormalities may approach 15% to 27%. Historically, the uterine septum has been approached via laparotomy through either a Tompkins or Jones procedure. These successful, but highly morbid, procedures require laparotomy with significant hospital stays, subsequent cesarean delivery, and have carried a high risk of adhesion formation. More recently, this surgery has been supplanted by hysteroscopy or other minimally invasive methodologies. Objective To assess the relation between the vascularity of uterine septum and obstetric performance with Transvaginal 3D Power Doppler Ultrasound. Patients and Methods Early Cancer Detection Unit and Ultrasound and Fetal special care Unit in Ain Shams University Maternity Hospital (ASUMH). Recruitment took place between May 2017 and November 2018. Cross-sectional study. The study included 30 cases of women with uterine septum. Intervention: Transvaginal 3D power Doppler ultrasound was done to all cases with septal volume and vascularity assessment using VOCAL system and Histogram facility. The study included 30 patients with septate uterus, twelve of them suffered from 1ry infertility while the other eighteen suffered from recurrent abortion. Results There was statistical significant difference between the two groups regarding vascularity (VI, FI, and VFI) of septum (P &lt; 0.05). Conclusion The vascularity of septate uterus is variable. The power Doppler indices shows that septate uterus in cases with recurrent abortion is highly vascular while in cases with 1ry infertility shows low vascularity. Highly vascular septum may be a site of implantation which may be a cause of recurrent abortion thus; excision of the septum may help prevent recurrent abortion, while low vascular septum may prevent implantation which may be a cause of infertility thus; incision of the septum may help in treatment of infertility. Correlation with histopathologic features of septum may be required to decide the best management of the septum.

Immunodeficiency Disorders

Hematology ◽  
2003 ◽  
Vol 2003 (1) ◽  
pp. 314-330 ◽  
Author(s):  
Max D. Cooper ◽  
Lewis L. Lanier ◽  
Mary Ellen Conley ◽  
Jennifer M. Puck
Keyword(s):  
B Cells ◽  
B Cell ◽  
Host Defense ◽  
Diagnosis And Treatment ◽  
T And B Cells ◽  
Phagocytic Cells ◽  
Effector Cells ◽  
Immunodeficiency Diseases ◽  
Cellular And Humoral Immunity ◽  
And Function

Abstract Hematological complications occur frequently in patients with both primary and secondary immunodeficiency disorders. Anemia, thrombocytopenia or leukopenias may bring these individuals to the attention of hematologists. Conversely, evidence suggesting a lymphoproliferative disorder may be the cause for referral. This session will provide an update on the diagnosis and treatment of immunodeficiency diseases ranging from isolated defects in antibody production to the severe combined immunodeficiencies (SCID). Immunodeficiency diseases have traditionally been defined as defects in the development and function of T and B cells, the primary effector cells of specific cellular and humoral immunity. However, it has become increasingly evident that innate immune mechanisms contribute greatly to host defense, either through acting alone or by enhancing specific T and B cell responses. In Section I, Dr. Lewis Lanier reviews the burgeoning information on the extensive families of activating and inhibitory immunoreceptors that are expressed on NK cells, dendritic cells, T and B cells, and phagocytic cells. He provides an overview on the biological functions of these receptors in host defense. In Section II, Dr. Mary Ellen Conley defines the spectrum of antibody deficiency disorders, the most frequently occurring types of primary immunodeficiencies. She covers the different defects in B-cell development and function that lead to antibody deficiencies, and includes diagnosis and therapy of these disorders. In Section III, Dr. Jennifer Puck discusses the diagnosis and treatment of the different types of SCID. She describes the genetic basis for SCID, and the benefits, pitfalls, and complications of gene therapy and bone marrow transplantation in SCID patients.

Diagnosis and treatment of uterine septum

1996 ◽  
Vol 3 (4) ◽  
pp. S1 ◽  
Author(s):  
LV Adamian ◽  
VI Kulakov ◽  
SI Kiselev ◽  
ZR Zurabiana ◽  
AZ Khashukoeva ◽  
...  
Keyword(s):  
Diagnosis And Treatment ◽  
Uterine Septum

scholarly journals Hysteroscopic polypectomy versus expectant management in endometrial polyps in asymptomatic infertile women: a meta-analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 3096
Author(s):  
Tauane Bahia Modesto ◽  
Amanda Tamiris Barbosa Dias ◽  
Sofia Andrade De Oliveira
Keyword(s):  
Pregnancy Rate ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Implantation Rate ◽  
Endometrial Polyp ◽  
Structural Abnormality ◽  
Endometrial Polyps ◽  
Intrauterine Abnormalities

Background: Endometrial polyp is a hyperplastic structural abnormality of the uterine cavity and is one of the most commonly found intrauterine abnormalities. The endometrial polyp is mostly asymptomatic and sometimes diagnosed only during infertility investigation. The influence of endometrial polyps on female infertility is not completely understood, however, due to the possibility of endometrial polyps influencing fertility, their removal is usually performed in women undergoing infertility treatment.Methods: This meta-analysis was performed through an electronic search using MEDLINE, PubMed in October 2017, bringing together the terms of interest in order to select studies that would compare polypectomy and expectant management for endometrial polyps in sub fertile women. Four articles were selected according to the inclusion and non-inclusion criteria.Results: Five variables were collected from the selected articles to be compiled and analyzed (rate of live births per transferred embryo, chemical pregnancy rate, spontaneous abortion rate, implantation rate and clinical pregnancy rate), none of which showed any difference statistically significant in conduct.Conclusions: The data concluded that there is no statistical significance between expectant management and polypectomy.

scholarly journals Short - Term Effects of Eccentric Hip Abductors and Lateral Rotators Strengthening In Sedentary People with Patellofemoral Pain Syndrome on Pain and Function : A Randomized Control Trail

2016 ◽  
Vol 06 (01) ◽  
pp. 068-073
Author(s):  
Kavitha Shetty ◽  
Lawrence Mathias ◽  
Mahesh V. Hegde ◽  
Sukumar Shanmugam
Keyword(s):  
Statistical Significance ◽  
Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Short Term ◽  
Strengthening Exercises ◽  
Post Test ◽  
Hip Abductor ◽  
And Function ◽  
Experimental Group

Abstract Purpose: To investigate the influence of additional eccentric strengthening to the hip abductor and lateral rotator musculature on pain and function in sedentary people with Patellofemoral pain syndrome (PFPS). Methods: 30 sedentary patients between 18 and 40 years of age, with a diagnosis of PFPS, all the subjects received treatment for a period of 4weeks and the subjects were randomly assigned to Control group (CG) and Experimental group (EG). The patients in the Control group (n = 15) performed a conventional knee-stretching and strengthening program, whereas, patients in the Experimental group (n = 15) performed the same exercises as those in the control group ,in addition received eccentric strengthening exercises for the hip abductors and lateral rotators. An 11-point numeric pain rating scale (NPRS), the Lower Extremity Functional Scale (LEFS) and the Anterior Knee Pain Scale (AKPS) were used as outcome measures during the baseline and at the end of 4weeks . Results: Statistics were retrieved using SPSS.16, paired 't' test was conducted to compare AKPS and LEFS values ,whereas, Mann- Whitney U test was used for NPRS value between the groups. After 4 weeks of treatment, the control group, pre and post-test value for AKPS (p<0.001),LEFS (P<0.001),NPRS (p<0.001) shows a statistical significance and even in the experimental group, pre and post-test value for AKPS (p<0.001),LEFS (P<0.001),NPRS (p<0.001) shows a statistical significance in pain and function, but comparing both the group experimental group is significantly more better AKPS (p=0.002),LEFS (P<0.001),NPRS (P<0.001) then a control group. Conclusion: short term Knee strengthening exercises supplemented by eccentric hip abductor and lateral rotator musculature–strengthening exercises were more effective than knee exercises alone in improving function and reducing pain in sedentary people with PFPS.

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