Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child.

Objective: To highlight the possible correlation between deep-infiltrating endometriosis (DIE) resection and subsequent uterine rupture. Design: Case series and review of the literature. Setting: Endometriosis referral hospitals. Patient(s): Seven young women who underwent laparoscopic resection of DIE, six of whom had uterine rupture before or during labor; the seventh patient had a posterior wall defect that placed her at increased risk of future uterine rupture. Intervention(s): Diagnosis of uterine rupture before or during labor in patients with a history of prior resection of DIE, leading to delivery by emergency delivery section or emergency laparotomy for exploration and repair. Main Outcome Measure(s): Immediate neonate and maternal salvaging caesarean delivery or laparotomy followed by surgical correction of the rupture. Result(s): As of 2019, no publications in the literature had considered uterine rupture among the obstetric complications of endometriosis. The reporting of such findings is crucial because of the increase in surgical management of endometriosis. We report seven cases of uterine rupture in pregnancy in women who had undergone resection of DIE. In six patients, surgeons found uterine rupture at the level of the previous resected endometriosis and diagnosed a posterior wall defect at the same level in one patient. Conclusion(s): Our case series sheds light on the potential increased risk of uterine rupture during pregnancy among women who have had a prior resection of DIE. In future, if these patients are considered high-risk pregnancy cases, their care should be managed by highrisk obstetric specialists.

OBJECTIVE: A systematic review and meta-analysis to assess the assess the effectiveness of mock embryo transfer. We also identified the number of fertility clinics offering mock embryo transfer, the stated justification for offering the procedure, and the associated additional cost.DESIGN: Systematic examination of fertility clinic websites and systematic review of published randomized trials evaluating the effectiveness of mock embryo transfer.MATERIALS AND METHODS: We identified fertility clinic websites using google.com. Information was extracted from individual clinic websites related to the provision of embryo transfer and associated costs. The systematic review of published randomized trials was prepared by following Cochrane Collaboration guidelines. Selection of studies, assessment of trial quality, and extraction of relevant data were performed independently by two researchers. Summary estimates and 95% confidence intervals were calculated using random-effects methods.RESULTS: Worldwide 1,200 clinics and fertility networks, have been identified to offer mock embryo transfer at an average cost of $350 (range $240 to $500). 40 % of identified clinic websites stated that mock embryo transfer was associated with improved success rates.The systematic search of published literature identified two randomized trials, reporting data from 499 women. Live birth was not reported. Mock embryo transfer increased pregnancy confirmed by ultrasound (OR 1.80, 95% CI 1.07-3.05) when compared to routine care. Mock embryo transfer did not increase biochemical pregnancy (OR 0.91, 95% CI 0.28-2.99) when compared to routine care. There was poor reporting of other secondary outcomes, including ectopic pregnancy, miscarriage, and other adverse events.CONCLUSIONS: There is insufficient evidence to support the routine use of mock embryo transfer. The uncertainty regarding the procedure's effectiveness should be presented alongside online information pertaining to mock embryo transfer, discussed openly during consultations, and summarised within accessible patient information leaflets and websites. Regulators, including the Human Embryology and Fertility Authority, should consider treating mock embryo transfer as an add on. Using their established system, it would currently be classified as amber: do not offer routinely. Mock embryo transfer may have a role in selected cases.

influx of assisted reproductive technology (ART) and services promote price transparency, with detailed costs of services listed on websites. Given current market trends, we sought to determine how existing clinics perform in terms of price transparency and to what extent they provide information on available discounts and financial assistance.DESIGN: Cross-sectional analysis of Society for Assisted Reproductive Technology (SART) registry clinics.MATERIALS AND METHODS: Clinics were identified through the SART website clinic search function on 4/14/19. Military clinics and those clinics without a website were excluded. Between 4/15/19 and 4/22/19, each clinic's website was queried. Practice location (city, state) and type (private vs. academic vs. other [e.g.: managed care]) were recorded. Prices for consultation, intrauterine insemination (IUI; including monitoring and sperm preparation), in vitro fertilization (IVF; excluding pre-implantation genetic testing), frozen embryo transfer (FET), and oocyte cryopreservation (OC) were recorded. Mean costs were calculated for each reported price.RESULTS: 382 clinics were listed on the SART website and 375 met study inclusion criteria. Table 1 illustrates the number and percentage of clinics that provided costs for services, information on discounts, and available financial assistance on their websites. Only 22.8% (67/293) of private practices and 11.7% (9/77) of academic practices reported the price of one or more services.

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Methodology Eligible patients had FIGO 2009 stage IB2-IIIB cervical cancer with no or only limited (£5 mm) vaginal involvement. Comprehensive assessment of vaginal changes was done before treatment, at 4-6 weeks and 3, 6, 12 and 24 months thereafter using CTCAE v3.0 and additional assessments. PRO were assessed at the same timepoints using validated Quality of Life (EORTC QLQ-C30 and CX24) and sexual questionnaires. Statistical methods included generalized linear mixed model analysis and Spearman's rho correlation coefficients.

Introduction/Background Total vulvectomy is associated with high morbidity due to the frequency of healing complications. Skin flap plasty has improved management but there is a risk of necrosis, flap collapse and infection, hence the interest in hyperbaric oxygen therapy (HBOT) as an adjuvant treatment for these complications. Methodology We compare the efficacy of HBOT on vulvectomy healing in two 60-year-old patients who underwent radical total vulvectomies in our department, the first for highgrade squamous intraepithelial lesions and the second for stage Ib squamous cell carcinoma of the vulva.