incomplete abortion

不完全流产
  • 文章类型: Case Reports
    子宫切除术标本中的不寻常发现。与堕胎史有关。病因尚不清楚。临床上它表现为不孕症,慢性盆腔疼痛,月经过多,还有阴道分泌物.治疗是通过斜视切除。
    An unusual finding in hysterectomy specimen. Associated with a history of abortion. Etiology remains unclear. Clinically it presents with infertility, chronic pelvic pain, menorrhagia, and vaginal discharge. Treatment is by hysterescopic excision.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    流产过程中胎儿骨骼的宫内滞留时间延长可导致继发性不孕。这篇综述旨在提高产科/妇科医生对这种情况可能性的认识。共17例病例报告,该综述包括7例病例系列和1例回顾性研究,共有75名患者。总的来说,60%的人在妊娠中期终止妊娠,而20%的人在妊娠早期终止。69%的患者采用宫腔镜切除术切除宫内胎儿骨骼。总的来说,59%的患者在手术后受孕,尽管存在子宫内骨骼,但仍有1%的人受孕,24%的人在研究时无法受孕,16%的人结果未知。经阴道超声检查用于41例(55%)患者的诊断,21例(28%)患者使用盆腔超声。总之,继发性不孕症是扩张和刮宫手术后的常见病,部分原因是胎儿骨保留。准确诊断和治疗的金标准是宫腔镜检查。
    Prolonged intrauterine retention of fetal bones during an abortion procedure can lead to secondary infertility. This review aimed to raise awareness among obstetric/gynaecologists about the possibility of this condition. A total of 17 case reports, seven case series and one retrospective study were included in this review, with 75 patients in total. Overall, 60% had a pregnancy termination in the second trimester, while 20% had a termination during the first trimester. Hysteroscopic resection was used to remove the intrauterine fetal bones in 69% of patients. In total, 59% of patients conceived following the procedure, 1% conceived despite the presence of intrauterine bones, 24% could not conceive at the time of the study and 16% had an unknown outcome. Transvaginal ultrasound was used for diagnosis in 41 (55%) patients, while pelvic ultrasound was used in 21 (28%) patients. In conclusion, secondary infertility is a common occurrence after a dilation and curettage procedure partially due to fetal bone retention. The gold standard for an accurate diagnosis and treatment is hysteroscopy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:角度妊娠的特征是在子宫外侧角度植入子宫输卵管交界处内侧。这是一种罕见的产科并发症,伴有严重的并发症,如子宫破裂和胎盘滞留。
    方法:我们报告1例宫腔镜诊断和治疗的不完全流产角状妊娠。在这种情况下,两名患者均为不完全流产行宫腔镜手术,在宫腔镜的帮助下,检测到角度妊娠。
    结论:宫腔镜可以更直观地显示子宫腔内的状况,减少术中和术后并发症,缩短患者的住院时间。在宫腔镜检查期间,在子宫腔的上外侧可以看到角度妊娠。根据临床病例调查结果,这是第一例宫腔镜治疗不完全流产角状妊娠的报告。
    BACKGROUND: Angular pregnancy is characterized as implant medial to the uterotubal junction in lateral angular of uterine. It was a rare obstetric complication with severe complications like uterine rupture and retained placenta.
    METHODS: We report a case of 2 incomplete aborted angular pregnancy that was diagnosed and treated with hysteroscopy. In this case, both of patient were performed operative hysteroscopy for incomplete abortion, and with the assistance of hysteroscopy, the angular pregnancy was detected.
    CONCLUSIONS: Hysteroscopy can more intuitively display the conditions inside the uterine cavity, reduce the intraoperative and postoperative complications, and shorten the hospitalization time of patients. During hysteroscopy, angular pregnancy can be visualized in the upper lateral side of the uterine cavity. Based on the investigation results of clinical cases, this is the first case report of hysteroscopy in the treatment of incomplete aborted angular pregnancy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    关于预防性抗生素在预防与用于不完全流产的外科手术相关的生殖道感染(GTI)中的作用的发现是相互矛盾的。一些报告说,与使用抗生素预防相关的感染减少,而其他人发现GTI没有显着降低。
    系统地合成预防性抗生素与安慰剂相比在接受不完全流产手术的妇女中的作用的证据。
    2020年2月,PubMed,搜索Embase和CochraneCentral的对照试验登记册,以获取相关已发表的随机对照试验。
    随机对照试验报告不完全流产手术后GTI,并比较抗生素预防与安慰剂。
    使用逆方差异质性模型的Meta分析包括亚组,并进行先验确定的敏感性分析。使用建议评估分级来评估证据质量,开发和评估(等级)。
    共有16.178名女性参与了1975年至2019年间发表的24项符合条件的随机对照试验。汇总估计显示,在使用预防性抗生素的患者中,不完全流产后外科手术后GTI的风险显着降低(相对风险[RR]=0.72;95%CI0.58-0.90;I2=49%)。在低收入和中等收入国家,抗生素对女性没有显著影响(三项研究,3579名参与者,RR=0.90;95%CI0.50-1.62;I2=63%),但在高收入国家的女性中具有临床和统计学意义(21项研究,12.599名与会者,RR=0.67;95%CI0.53-0.84;I2=44%),根据等级评估,有很强的证据。
    这项研究提供了证据,表明在接受不完全流产手术的妇女中,抗生素预防有利于减少流产后GTI。低收入和中等收入国家需要更多的研究。
    不完全流产后预防性使用抗生素可有效降低GTI。低收入和中等收入国家需要更多的研究。
    Findings about the effect of prophylactic antibiotics in preventing genital tract infection (GTI) associated with surgical procedures used for incomplete abortions are conflicting. Some reported a decrease in infection associated with the use of antibiotic prophylaxis, whereas others found no significant reduction in GTI.
    To synthesise systematically the evidence on the effect of prophylactic antibiotics compared with placebo in women undergoing surgical procedures for incomplete abortion.
    In February 2020, PubMed, Embase and Cochrane Central for Register of Controlled Trials were searched for relevant published randomised controlled trials.
    Randomised controlled trials reporting GTI following surgical procedures for incomplete abortion and comparing antibiotic prophylaxis with placebo.
    Meta-analysis using inverse variance heterogeneity model included subgroup and sensitivity analyses determined a priori were conducted. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
    A total of 16 178 women who participated in 24 eligible randomised controlled trials published between 1975 and 2019 were included. Pooled estimates showed the risk of GTI following surgical procedures after incomplete abortion was significantly lower among those who had prophylactic antibiotics (relative risk [RR] = 0.72; 95% CI 0.58-0.90; I2  = 49%). There was no significant effect of antibiotics in women in low- and middle-income countries (three studies, 3579 participants, RR = 0.90; 95% CI 0.50-1.62; I2  = 63%), but it was clinically and statistically significant among women high-income countries (21 studies, 12 599 participants, RR = 0.67; 95% CI 0.53-0.84; I2  = 44%), with a strong level of evidence as assessed by GRADE.
    This study provides evidence that antibiotic prophylaxis is beneficial in reducing post-abortion GTI among women undergoing surgical procedures for incomplete abortion. More studies are needed from low- and middle-income countries.
    Prophylactic antibiotics after incomplete abortion are effective in reducing GTI. More studies are needed from low- and middle-income countries.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    背景:先前的系统评价得出的结论是,由非医生提供者进行的医疗终止妊娠(TOP)可能与医生提供的药物一样有效且安全。非医生提供者对不完全流产的药物治疗以及接受治疗的妇女接受非医生提供者的TOP之前没有进行过审查。
    目的:为了审查有效性,安全,和早期妊娠医学TOP的可接受性,包括不完全流产的治疗,由训练有素的非医生提供者提供。
    方法:开发了使用适当医学主题词的搜索策略。电子数据库(PubMed,Popline,科克伦,CINAHL,Embase,和ClinicalTrials.gov)从开始到2016年4月进行了搜索。纳入随机对照试验和比较观察性研究。
    方法:对纳入的随机对照试验进行了关于有效性和女性可接受性结局的Meta分析。使用GRADE方法评估研究局限性来确定证据的确定性,效果的一致性,不精确,间接性和出版偏见。
    结果:共纳入6篇论文。非医生提供者进行的不完全流产的医疗TOP和医疗治疗可能与医生进行的一样有效(RR1.00;95%CI0.99-1.01)。妇女的接受,报告为对分配的提供商的总体满意度,组间可能同样高(RR1.00;95%CI1.00-1.01)。
    结论:由受过培训的非医生提供者提供的不完全流产的医疗TOP和医疗治疗可能与医生提供的妇女一样有效和可接受。
    结论:由医生和非医生进行的医学终止妊娠同样有效且可接受。
    BACKGROUND: Previous systematic reviews have concluded that medical termination of pregnancy (TOP) performed by non-doctor providers may be as effective and safe as when provided by doctors. Medical treatment of incomplete miscarriage by non-doctor providers and the treated women\'s acceptance of non-doctor providers of TOP has not previously been reviewed.
    OBJECTIVE: To review the effectiveness, safety, and acceptability of first-trimester medical TOP, including medical treatment for incomplete miscarriage, by trained non-doctor providers.
    METHODS: A search strategy using appropriate medical subject headings was developed. Electronic databases (PubMed, Popline, Cochrane, CINAHL, Embase, and ClinicalTrials.gov) were searched from inception through April 2016. Randomised controlled trials and comparative observational studies were included.
    METHODS: Meta-analyses were performed for included randomised controlled trials regarding the outcomes of effectiveness and acceptability to women. Certainty of evidence was established using the GRADE approach assessing study limitations, consistency of effect, imprecision, indirectness and publication bias.
    RESULTS: Six papers were included. Medical TOP and medical treatment of incomplete miscarriage is probably equally effective when performed by non-doctor providers as when performed by doctors (RR 1.00; 95% CI 0.99-1.01). Women\'s acceptance, reported as overall satisfaction with the allocated provider, is probably equally high between groups (RR 1.00; 95% CI 1.00-1.01).
    CONCLUSIONS: Medical TOP and medical treatment of incomplete miscarriage provided by trained non-doctor providers is probably equally as effective and acceptable to women as when provided by doctors.
    CONCLUSIONS: Medical termination of pregnancy performed by doctors and non-doctors can be equally effective and acceptable.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Case Reports
    Publications describing the diagnosis and treatment of anterior dislocation of the sacroiliac joint are scarce. We report the case a 19-year-old female at 8 weeks\' gestation who presented with anterior fracture dislocation of the right sacroiliac joint, posterior fracture dislocation of the left sacroiliac joint (crescent fracture), and incomplete abortion resulting from high energy trauma. Orthopedic surgery involved standard anterior sacroiliac joint plating using an ilioinguinal approach combined with a modified Stoppa approach. Three attempts at complete abortion failed. Complete abortion was eventually achieved by dilatation and curettage two weeks after orthopedic surgery. Our findings reveal a need to improve techniques for diagnosis and treatment of anterior fracture dislocation of the sacroiliac joint, so greater attention can be paid to the rapid and effective management of associated comorbidities, and those resulting from the initial trauma.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号