Bleeding after gynecological surgery remains an infrequent life-threatening complication, demanding appropriate medical and surgical management. Classified as early/“reactionary” and delayed/secondary, unexpected postoperative hemorrhage may arise regardless of the route or subtype of hysterectomy. Timely recognition and prompt intervention to arrest bleeding are essential strategies for the suitable outcome of the patient. The present chapter presents an overview on different aspects of bleeding after hysterectomy such as incidence rate, risk factors, mechanisms, and management techniques aiming to expand knowledge and skills in recognizing and treating this unpredicted potentially serious problem. Furthermore, we intend to offer a guide toward standardizing treatment practice across bleeding issues following hysterectomy considering clear recommendations and algorithms.
The purpose of this work is to determine perspectives, misconceptions, psychology adjustments and useful strategies of women living with dilemmas about their malignant lesions which can be detected through the colposcopy. Colposcopic assessment following abnormal Pap test has resulted in a long list of concerns: fear of having cancer, periodic obligations related to follow-up, balancing treatment of premalignant disease with quality of life, pain or discomfort and long-term impact on their families or limited social support. How prepared are they to adapt to their diagnosis? New diagnosis results in patient not being able to listen well or to understand her medical situation. The success of the outcome and procedure takes time to deduce the concerns she has regarding her diagnosis, treatment and appropriate follow-up. Several physicians endorse a wide range of barriers with respect to diagnosis and management of the disease: organizational or patient issues. Furthermore, patient appears to be important for the efective treatment than to identify and assess psychosocial problems among women diagnosed with cancer. In conclusion, physician provides efective treatment, but fails to address psychosocial issues associated with the illness. It is necessary to deine the condition more clearly by studying patients and their psychosocial problems.
The aim of our study was to determine if ultrasound (US) measurements for fetal biometry and cervical length has a potential predictive value of cesarean delivery in nulliparas. Methods: US parameters studied included abdominal circumference/ biparietal diameter (AC/BPD), abdominal circumference/femur length (AC/FL) and cervical length. 203 pregnancies were followed in the third trimester at 28-32 weeks of gestation. Sonographic variables were studied using a regression analysis as predictors of cesarean delivery in nulliparas. All gravidas had a normal pregnancy follow-up until 32 weeks of gestation. Results: A total of 203 pregnant women had participated in the study and of this 23 (11.3%) underwent an emergency cesarean delivery in labor. Women viable singleton pregnancies were selected. A correlation analysis between the mean cervical length, the mean AC/BPD and the mean AC/FL ratio showed non-significant correlation (P > 0.05). For all parameters evaluated, regression analysis demonstrated also a non-significant contribution (P > 0.05) in predicting the risk of cesarean delivery. Conclusions: Ultrasound assessment of the cervical length and fetal biometric ratio at third trimester can't predict the risk of Cesarean delivery in nulliparas. P16.10 Bishop score and transvaginal ultrasound cervical assessment for the prediction of successful induction of labour
To evaluate sonographic, power-Doppler features and histological findings in cases of small unilocular-solid cyst in a normal-size ovary. Methods: All consecutive women with small ovarian unilocularsolid cyst in normal-size ovary detected by transvaginal ultrasound, were included in the study. Patients had either follow-up ultrasound examination every three months or underwent surgical removal of the cyst. CA 125 was also evaluated. Histological findings were reviewed. Results: A total of 13 cases were identified. The median age of the patients was 46 years (range 26-75). CA 125 was elevated (> 35 UI/mL) in 4/13 (31%) cases. The median size of the cyst was 22 mm (range 32-15). The vascularization was present in 9/13 (69%) cases. Free fluid in the pouch of Douglas was detected in 2/13 cases (15%). Six of 13 (46%) women received follow-up ultrasound examination every three month. Seven of 13 (54%) underwent laparoscopic removal of the cyst. Hystological diagnosis of malignancy (one carcinoma, and two borderline tumors) was recorded in 3/13 (23%) cases and of benign lesion (serous cistoadenoma) in 4/13 (31%). Conclusions: These data suggest that the presence of a papillary projection is more important than the size of the cyst. Small unilocular solid cysts even in a normal-size ovary have substantial risk of malignancy.
Oral poster abstracts next to entry fields improves interrater agreement in Electronic Data Capture (EDC) software. Methods: With a 2-week interval, 5 clinicians trained in gynecologic ultrasound evaluated 100 ultrasound images according to the IETA terminology. During the first series just the questions were shown; during the second pictograms were shown next to the possible selections for multiple-choice questions. Half of the images were taken during unenhanced ultrasound exams, and the other half during sonohysterography. We used the jackknife technique to sample Fleiss' kappa-coefficient for all variables included, and applied a t-test on the jackknife samples obtained from both series. We took P < .05 to be significant. Results: For the unenhanced ultrasound images, interrater agreement for variables with pictograms in the second series increased significantly for all variables except ''synechiae'' and ''vascular pattern'' (Table 1). For the sonohysterography images, results were less consistent. Conclusions: Showing the IETA pictograms next to questions can significantly improve interrater agreement for some variables. Other studies with imaging modalities are likely to improve interrater agreement for some variables when showing pictograms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.