Purpose: To date, only a few cases of intramural pregnancy have been recorded. We aim to report an uncommon case of intramural pregnancy misdiagnosed as gestational trophoblastic neoplasia, emphasizing that earlier surgical intervention may contribute to timely diagnosis and precise treatment.Methods: Relevant articles published over the past five years were identified through a literature searching, and related references in those literatures were also manually searched to find additional articles.Results: Nineteen cases in total including this report were reviewed. Most patients possessed a history of intrauterine operation or uterine surgery. Diagnoses were mainly made by imageological examinations. And surgical procedure tended to be the dominant treatment of such diseases.
Conclusions:Intramural pregnancy is considered to be the rarest type of ectopic gestation, where the gestational sac is completely encircled by myometrium. The non-specific clinical manifestations and non-uniform imageological criteria lead to the difficult diagnoses. However, earlier surgical management may contribute to timely diagnosis and precise treatment.
Objective: The female reproductive tract is a significant microecological region, and its micro-environment can directly affect women’s cervical health. This research aimed to study the association between vaginal microecology and human papillomavirus infection (HPV) infection as well as cervical intraepithelial neoplasia(CIN).
Methods:A retrospective cohort study enrolled 2,147 women who underwent colposcopy between August 2021 and August 2022. The relationship between vaginal microecology and HPV infection as well as cervical lesions were assessed using the chi-square test, univariate, multivariate logistic regression analysis and Cochran-Armitage trend test.
Result:HPV infection was linked to imbalance of vaginal microecology [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.66–5.43; p < 0.001], among which clue cell (OR 1.59, 95% CI 0.99–2.54; p = 0.054) and sialidase (OR 1.54, 95% CI 1.01–2.35; P < 0.046) were considered as significant risk factors. Further analysis showed that the occurrence of vaginal microecological disorder was more likely to be detected in HPV 16/18 subtype (OR 9.86, 95% CI 2.37–41.80; P = 0.002). Although there existed no significant correlation between the overall disorder rate of vaginal microecology and the degree of cervical lesions (P > 0.05), the abnormal proportion of PH value (OR 2.6, 95% CI 1.63–10.42; P = 0.001) and vaginal cleanliness (OR 2.6, 95% CI 1.36–4.0; p = 0.004) increased as the histological diagnoses progressed.
Conclusion:Vaginal microecology played a vital role in HPV infection and the progression of cervical lesions. Detection of vaginal secretion may contribute to discovering micro-environmental modulation therapeutic targets with probiotics, reducing the incidence of cervical cancer.
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