1.  Title: Sonographic findings of uterine rupture with expulsion of the fetus into broad ligament. Author: Attarde VY; Patil P; Chaudhari R; Zope N; Apte A Source: Journal of Clinical Ultrasound. 2009 Jan;37(1):50-2. Abstract: We report the sonographic findings of a rare case of uterine rupture with extrusion of the fetus into the broad ligament during a second-trimester abortion. Sonography revealed the empty uterus with an indistinct defect on the side wall and the dead fetus lying outside, surrounded by a thin membrane. At surgery, the uterine rupture was confirmed with the fetus lying in the broad ligament. This study shows the importance of timely sonography in second-trimester abortion, enabling immediate management and preventing further complications. Language: English Keywords: INDIA | RESEARCH REPORT | CASE STUDIES | WOMEN | UTERINE PERFORATION | PREGNANCY, SECOND TRIMESTER | ULTRASONICS | UTERINE EFFECTS | ABORTION | MEDICAL PROCEDURES | PREGNANCY COMPLICATIONS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Perforations | Diseases | Pregnancy | Reproduction | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Fertility Control, Postconception | Family Planning Document Number: 330846 Notification |
| 2. Peer Reviewed Title: Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections. Author: Ben-Ami I; Schneider D; Svirsky R; Smorgick N; Pansky M; Halperin R Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):154.e1-5. Abstract: OBJECTIVE: To assess whether there is an increased perioperative risk in termination of late second-trimester pregnancy after multiple cesarean sections by laminaria dilatation and evacuation. STUDY DESIGN: During the period between January 2002 and June 2008, 636 consecutive patients underwent late second-trimester (17-24 weeks) pregnancy terminations by dilatation and evacuation. Patients were divided into 3 subgroups: those with no previous cesarean section (n = 545), those with 1 previous cesarean section (n = 59), and those with several previous cesarean sections (n = 32). RESULTS: There were no significant differences in major perioperative complications, such as anesthetic complications, need for blood transfusion, and cervical lacerations comparing the 3 subgroups. Importantly, there were neither cases of uterine perforation nor retained products of conception in the 3 subgroups. CONCLUSION: Late second-trimester pregnancy termination after multiple cesarean sections by laminaria dilatation and evacuation is probably not associated with an increased perioperative risk. Larger studies are needed to empower this study. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | WOMEN | PREGNANCY, SECOND TRIMESTER | CESAREAN SECTION | ABORTION | SAFETY | UTERINE EFFECTS | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Public Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 342611 Notification |
| 3. Title: Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review. Author: Berghella V; Airoldi J; O'Neill AM; Einhorn K; Hoffman M Source: BJOG. 2009 Aug;116(9):1151-7. Abstract: BACKGROUND: Second trimester pregnancy induction with misoprostol in women with prior caesarean delivery is not well studied. OBJECTIVE: To estimate the risk of uterine rupture using misoprostol as an induction agent for pregnancy termination in the second trimester of pregnancy in women with prior caesarean delivery. SEARCH STRATEGY: Cases of women with a history of prior caesarean delivery and subsequent misoprostol induction for pregnancy termination in the second trimester (16-28 weeks) were obtained from two main data sources. First, a retrospective chart analysis was performed at Thomas Jefferson University Hospital and Christiana Hospital between 1998 and 2004. Second, multiple Medline, Scopus and POPLINE literature searches were performed. SELECTION CRITERIA: Case series and cohort studies of women with one or more prior caesarean delivery (of any type), and with a subsequent pregnancy with induction of labour for pregnancy termination at 16-28 weeks using misoprostol as the initial primary agent were included. Case reports were analysed separately. DATA COLLECTION AND ANALYSIS: Total cases were analysed by type and number of prior caesarean delivery, for the primary outcome of uterine rupture. MAIN RESULTS: The incidence of uterine rupture associated with second trimester misoprostol termination was 0.4% (2/461) in women with one prior low transverse, 0% (0/46) in those with two prior low transverse and 50% (1/2) in those with a prior classical caesarean delivery. One of the cases of uterine rupture in a woman with a prior low transverse caesarean required transfusion. None of the total eight cases (including case reports) of uterine rupture was associated with hysterectomy. CONCLUSIONS: Second trimester misoprostol termination appears safe among women with one prior low transverse caesarean birth, as it is associated with incidences of uterine rupture of 0.4% (95% confidence interval 0.08-1.67%), of hysterectomy of 0% and of transfusion of 0.2%. There are insufficient data on risk with more than one prior caesarean birth or with prior classical caesarean birth. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | ABORTION | CESAREAN SECTION | UTERINE EFFECTS | RISK FACTORS | INCIDENCE | Developed Countries | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Measurement Document Number: 342794 Notification |
| 4. Title: Novel progesterone receptor modulators with gene selective and context-dependent partial agonism. Author: Berrodin TJ; Jelinsky SA; Graciani N; Butera JA; Zhang Z; Nagpal S; Winneker RC; Yudt MR Source: Biochemical Pharmacology. 2009 Jan 15;77(2):204-15. Abstract: Progesterone receptor (PR) modulators are used in contraception and post-menopausal hormone therapy, and are under clinical development for reproductive disorders such as uterine fibroids and endometriosis. Development of tissue selective PR modulators (SPRMs) with reduced side effects and improved pharmacology represents a large unmet medical need in the area of women's health. One approach to addressing this need is to focus on the two PR isoforms PR-A and PR-B. In vitro and in vivo studies have revealed both distinct as well as overlapping gene regulation and functional responses of the two PR isoforms that suggests that PR-A selective modulators may retain a desired biological profile. We have identified a chemical series of 4-(4-chlorophenyl)-substituted piperazine carbimidothioic acid esters (PCEs) that have partial PR agonist activity and selectively activate some PR-A isoform regulated genes in T47D cells. However, full microarray analysis in these cells does not predict a global isoform selective profile for these compounds, but rather a unique gene-selective profile is observed relative to steroidal progestins. Using multiplexed peptide interaction profiling and co-activator recruitment assays we find that the mechanism of partial agonism is only partly defined by the ability to recruit known co-activators or peptides but also depends on the cell and promoter context of the gene under investigation. The data demonstrate global consequences of mechanistic and functional differences that can lead to selective biological responses of novel steroid receptor modulators. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | UTERINE EFFECTS | ENDOMETRIOSIS | NEEDS | WOMEN'S HEALTH | PROGESTERONE | SCREENING | LABORATORY PROCEDURES | Developed Countries | North America | Americas | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Economic Factors | Health | Progestational Hormones | Hormones | Endocrine System | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses Document Number: 329730 |
| 5. Title: Expectant management of pregnancy-related high-velocity uterine arteriovenous shunt diagnosed after abortion. Author: Degani S; Leibovitz Z; Shapiro I; Ohel G Source: International Journal of Gynaecology and Obstetrics. 2009 Jul;106(1):46-9. Abstract: OBJECTIVE: To assess sonographic and clinical outcome in women with pregnancy-related uterine arteriovenous malformations (AVMs) diagnosed after abortion. METHOD: Twelve patients diagnosed as having AVMs after abortion were followed-up until resolution of the lesions. RESULTS: The 9 asymptomatic patients were managed expectantly for 4 to 10 weeks without further complications. None of the 12 required aggressive interventions such as transcatheter arterial embolization, and 6 had uncomplicated pregnancies after resolution of the lesions. CONCLUSION: Expectant management is an option in many women with pregnancy-related uterine AVMs. Language: English Keywords: ISRAEL | RESEARCH REPORT | WOMEN | POSTABORTION | POSTABORTION CARE | UTERINE EFFECTS | MANAGEMENT | ULTRASONICS | Developed Countries | Middle East | Demographic Factors | Population | Reproduction | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Organization and Administration | Medical Procedures | Medicine Document Number: 342604 |
| 6. Title: [Appendix protrusion from perforation of uterus--the rare complication during abortion] Protruzia apendixu cez perforacny otvor v cervixe maternice ako zriedkava Author: Lakyova L; Dankovcik R; Kudlac M; Mikulova J; Radonak J Source: Ceska Gynekologie. 2009 Feb;74(1):67-9. Abstract: AIM: Point to an extremly rare complication of a curettage during abortion and follow up surgical treatment of this complicated state. CASE: In the case of 32 years old woman, multipara, was perforated cervix uteri during the abortion curettage and fat tissue of mesentery was aspirated into canulla. Apendix vermiformis was aspirated into cannula with its protrusion through the neck of the womb during repeated revision. Surgeon made appendectomy lege artis after abdomen revision and looking after haemoperitoneum. Because of serious devastation of right fallopian tube, salpingektomy was performed. Perforation of cervix in the lenght of three cm was sutured. Extensive incomplete rupture continuing from perforation gap was sutured from ligamentum sacrouterinum I.dx to fundus uteri. Intact foetus of 5,5 week of gestation was leaved in toto because of the high risk of the womb wall disruption during repeatedly attempted abortion. CONCLUSION: In case of the suspection of the uterus injury a revision and interdisciplinary approach to the solution of complications is necessary. Language: Slovene Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | ABORTION | CURETTAGE | UTERINE EFFECTS | UTERINE PERFORATION | MULTIPARITY | SURGERY | TREATMENT | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Perforations | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 341331 |
| 7. Title: Abnormal expression of MMP-9 and imbalance of MMP-9/TIMP-1 is associated with prolonged uterine bleeding after a medical abortion with mifepristone and misoprostol. Author: Li L; Zhou Z; Huang L Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(6):673-9. Abstract: OBJECTIVE: To investigate the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitory of metalloproteinase-1 (TIMP-1) in women who had undergone a medical abortion and explore their possible role in the mechanism of prolonged uterine bleeding after a mifepristone-misoprostol abortion. DESIGN: Cross-sectional study. SETTING: Tertiary referral university hospital. SAMPLE: Forty women were recruited following a medical abortion with mifepristone and misoprostol, 20 with duration of bleeding >14 days and 20 with duration of bleeding Keywords: CHINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | RU-486 | MISOPROSTOL | ABORTION | BLEEDING | ENDOMETRIUM | UTERINE EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins | Fertility Control, Postconception | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 341611 |
| 8. Title: Diffusion Weighted Imaging of the Uterus: Regional ADC Variation with Oral Contraceptive Usage and Comparison with Cervical Cancer. Author: Messiou C; Morgan VA; De Silva SS; Ind TE; Desouza NM Source: Acta Radiologica. 2009 May 15;:1-6. Abstract: Background: There is growing interest in diffusion weighted magnetic resonance imaging (MRI) of cervical carcinoma but normal uterine appearances and effects of the oral contraceptive pill (OCP) have not been described. Purpose: To establish apparent diffusion coefficient (ADC) values for normal regions of uterus, determine the effect of the OCP on these values, and compare them with ADCs from cervical cancer. Material and Methods: Twenty-seven premenopausal women (19 taking the OCP) with cervical intraepithelial neoplasia (CIN) were studied with T2W and diffusion weighted MRI (DW-MRI). Regions of interest were drawn on ADC maps by visual matching with T2W images on different zones of the uterus and values compared between women not taking and taking the OCP. A further group of 25 women with clinically obvious tumors of the cervix were also studied with T2W and DW-MRI and ADC values of tumor were compared with ADC values of cervical epithelium and stroma. Results: The ADC values of adjacent zones of the uterus and cervix were significantly different from one another (P<0.001). The junctional zone was seen as a band of restricted diffusion between endometrium and outer myometrium. The ADC value of the junctional zone of the uterus was significantly greater (P<0.001) in patients taking the OCP than those patients not taking the OCP. There was no significant affect of the OCP on the ADC values of other uterine zones. Conclusion: The zonal anatomy of the uterus is well demonstrated by DW-MRI with hormonal effects secondary to the OCP affecting junctional zone alone. ADC of cervical tumor is significantly different to cervical epithelium and stroma indicating a role in cervical cancer detection and local staging. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | SCREENING | CERVICAL CANCER | ORAL CONTRACEPTIVES | SIDE EFFECTS | UTERINE EFFECTS | EXAMINATIONS AND DIAGNOSES | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Treatment | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 341253 |
| 9. Peer Reviewed Title: Adolescent gynecology. Author: Sanfilippo JS; Lara-Torre E Source: Obstetrics and Gynecology. 2009 Apr;113(4):935-47. Abstract: Given new developments in the field of adolescent reproductive health, this review focuses on highlighting new guidelines and practice patterns in evaluation and management of adolescent gynecologic problems. First, understanding the proper techniques for the initial examination is key to establishing a long-term relationship with this age group. Reservations about the first gynecologic examination are common, and the practitioner's goal is foremost to make the patient as comfortable as possible. Preventive health in this patient population is key, and practitioners should become comfortable with providing education about topics as diverse as sexuality, eating disorders, and dating violence. Furthermore, the frequency with which teenagers report sexual activity and the high unintended pregnancy rate in this age group makes counseling regarding effective contraception essential. Additionally, practitioners are encouraged to take the opportunity to discuss the availability of the human papillomavirus (HPV) vaccine with adolescents. In 2007, adolescents were designated as a special population, given the frequency with which they acquire and clear mild HPV-related cervical dysplasia. More conservative treatment in this population is generally favored. During their transition through puberty, disorders of menstruation become the most common complaint requiring the attention of the gynecologist. Most commonly, anovulation serves as the cause behind such abnormal bleeding. Polycystic ovarian syndrome can develop in early puberty and carry its consequences into adulthood. Infertility, diabetes, and hirsutism mark the most important components of the syndrome and require age-appropriate management. Finally, the consequences of endometriosis on the future fertility of adolescents have brought early intervention to light. Recognition and prompt treatment are advocated to prevent the future implications of this disease. Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | EXAMINATIONS AND DIAGNOSES | ADOLESCENT HEALTH | GYNECOLOGY | PREVENTIVE MEDICINE | HPV | CYTOLOGY | HISTOLOGY | BLEEDING | UTERINE EFFECTS | ORAL CONTRACEPTIVES | TREATMENT | IUD | VAGINAL BARRIER METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Biology | Signs and Symptoms | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Contraceptive Methods | Contraception | Family Planning | Barrier Methods Document Number: 341227 |
| 10. Title: The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use. Author: Senthong AJ; Taneepanichskul S Source: Journal of the Medical Association of Thailand. 2009 Apr;92(4):461-5. Abstract: OBJECTIVE: Evaluate the efficacy of tranexamic acid and placebo for controlling irregular uterine bleeding in depot-medroxyprogesterone acetate (DMPA) users. MATERIAL AND METHOD: A double-blind, placebo-controlled study was conducted on 100 DMPA users attending the Family Planning Clinic King Chulalongkorn Memorial Hospital. All users had abnormal bleeding. They were randomly divided in two groups; a group of 50 received tranexamic acid, 250 mg four times a day for 5 days and another group of 49 received placebo in the same manner. One subject dropped out from the study. Total day of bleeding/spotting and percentage of women in whom bleeding was stopped were analyzed at the end of weeks 1 and 4. RESULTS: The percentage of subjects in whom bleeding was stopped during the first week after initial treatment was significantly higher in the tranexamic acid group than the placebo group (88% vs. 8.2%, p < 0.001). During the follow-up period (4 weeks after initial treatment), a bleeding-free interval of >20 days was found in 68% of subjects treated with tranexamic acid and 0% treated with placebo(p < 0.001). The mean number of bleeding/spotting days were also significantly different between the groups (5.7 +/- 2.5 vs. 17.5 +/- 7.2 days, p < 0.05). CONCLUSION: Tranexamic acid was more effective than placebo in short-term treatment of irregular uterine bleeding/spotting associated with DMPA use. Language: English Keywords: THAILAND | RESEARCH REPORT | WOMEN | UTERINE EFFECTS | BLEEDING | MEDROXYPROGESTERONE ACETATE | TREATMENT | Developing Countries | Asia, Southeastern | Asia | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341346 |
| 11. Peer Reviewed Title: Treatment of menorrhagia with the levonorgestrel releasing intrauterine system: effects on ovarian function and uterus. Author: Tasci Y; Caglar GS; Kayikcioglu F; Cengiz H; Yagci B; Gunes M Source: Archives of Gynecology and Obstetrics. 2009 Jul;280(1):39-42. Abstract: PURPOSE: To determine the effects of levonorgestrel-releasing intrauterine system (LNG-IUS) on ovarian functions, uterine and fibroid volume. METHODS: In this prospective study, LNG-IUS was inserted to 46 women with menorrhagia. The patients were evaluated for serum levels of hemoglobin, FSH, LH and estradiol, ovarian volume, uterine and fibroid volume and Kupperman index scores at the time of insertion, at 6th and 12th months. RESULTS: Serum FSH levels increased in 69% of the device users, the increase of serum FSH levels were statistically significant (P = 0.021). Regression analysis showed significant association between FSH levels and age of the patient (P = 0.001). There were no statistically significant differences in ovarian and uterine volumes. A statistically significant decrease in myoma volumes were observed (P = 0.04). CONCLUSION: The application of LNG-IUS in reproductive age women seems to decrease fibroid size and increase hemoglobin levels without any significant dysfunction on ovaries. Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | MENORRHAGIA | TREATMENT | IUD, HORMONE RELEASING | LEVONORGESTREL | OVARIAN EFFECTS | UTERINE EFFECTS | FIBROIDS | HEMOGLOBIN LEVEL | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Menstruation Disorders | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Uterus | Neoplasms, Benign | Neoplasms | Hemic System Document Number: 341969 |
| 12. Title: Levonorgestrel-releasing intrauterine system vs. endometrial thermal ablation for menorrhagia. Author: Theodoridis TD; Zepiridis L; Zafrakas M; Grimbizis G; Tantsis A; Kyrou D; Bontis JN Source: Hormones. 2009 Jan-Mar;8(1):60-4. Abstract: OBJECTIVE: To evaluate the efficacy of a Levonorgestrel-releasing Intrauterine System (LNG-IUS) in controlling menorrhagia in comparison with endometrial thermal rollerball ablation. DESIGN: Seventy-nine consecutive patients with menorrhagia underwent either LNG-IUS insertion (n=42) or hysteroscopical endometrial thermal rollerball ablation (n=37) in a prospective, observational, comparative study. Women reported duration of uterine bleeding in days prior to, and six and 12 months after each intervention. Prior to each intervention, endometrial, cervical or other pathological conditions of the genital tract were excluded. GnRH analogues for endometrial suppression were given for ten weeks before endometrial ablation but not prior to LNG-IUS insertion. RESULTS: There were no differences in duration of uterine bleeding before each intervention in the two groups. The duration of uterine bleeding was lower in the LNG-IUS group as compared with endometrial ablation at six (p<0.001) and 12 months (p<0.001) after each intervention. Furthermore, the effect on reduction of bleeding was stronger in the LNG-IUS group as compared with the endometrial ablation group at six (p<0.001) and 12 months (p<0.001). CONCLUSIONS: The LNG-IUS was more efficacious than endometrial thermal ablation in reducing duration of uterine bleeding at six and 12 months post-intervention. Language: English Keywords: GREECE | RESEARCH REPORT | CLIENTS | WOMEN | MENORRHAGIA | LEVONORGESTREL | BLEEDING | UTERINE EFFECTS | TREATMENT | PROGRAM EVALUATION | Europe, Southern | Europe | Developed Countries | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Menstruation Disorders | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Signs and Symptoms | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330908 |
| 13. Title: Sonography of uterine cavity contents after medical abortion. Author: van Bogaert LJ; Misra A Source: International Journal of Gynaecology and Obstetrics. 2009 Feb;104(2):150-1. Abstract: The main purpose of medical termination of pregnancy is to avoid surgical interventions such as manual vacuum aspiration or dilatation and curettage (D&C). Sonographic criteria to assess the uterine cavity after medical abortion would ensure a safe postabortion discharge without the need for surgical intervention. In South Africa, where termination of pregnancy is legal, registered midwives in outpatient settings systematically perform first trimester termination of pregnancy with manual vacuum aspiration 4 hours after administration of misoprostol. Mifepristone is not available in the public sector. The aim of the present study was to assess the clinical and sonographic features of the contents of the uterine cavity after medical abortion. The study was conducted between January 2 and March 31 2007 and enrolled consecutive women presenting for a first trimester ( Keywords: SOUTH AFRICA | RESEARCH REPORT | ABORTION | MISOPROSTOL | ULTRASONICS | UTERINE EFFECTS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 330834 Notification |
| 14. Peer Reviewed Title: Endometrial stromal lesions: A morphological and immunohistochemical study of short series. Author: Bal A; Mohan H; Aulakh R; Huria A Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):21-24. Abstract: Endometrial stromal tumours are rare and constitute less than 5% of uterine tumours. This study presents our experience of endometrial stromal tumours and their immunohistochemical profile. All cases reported as endometrial stromal tumors from January 2001 to December 2004 were extracted from the files of pathology department. Hematoxylin and eosin stained slides were reviewed and immunohistochemical staining for vimentin, desmin and cytokeratin was done in all cases. In all five cases of endometrial stromal tumors were retrieved from the records and constituted 0.3% of endometrial neoplasms. One case was diagnosed as endometrial stromal nodule and four cases were diagnosed as low-grade endometrial stromal sarcoma. Four out of five cases were confined to the uterine corpus. Only one case showed spread to the cervix and the fallopian tube. All tumors were negative for desmin and cytokeratin and showed only focal vimentin postivity. The diagnosis rests on morphological features mainly while immunohistochemical profile of these tumours is rather inconsistent. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | DATA ANALYSIS | WOMEN | UTERINE EFFECTS | UTERINE CANCER | NEOPLASMS | HISTOCHEMICAL EFFECTS | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Research Methodology | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cancer | Diseases | Cytologic Effects | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 322611 |
| 15. Title: Characterization of sequence variations within HPV16 isolates among Indian women: prediction of causal role of rare non-synonymous variations within intact isolates in cervical cancer pathogenesis. Author: Bhattacharjee B; Mandal NR; Roy S; Sengupta S Source: Virology. 2008 Jul 20;377(1):143-50. Abstract: We re-sequenced HPV16 genome (~6 kb) implicated in cervical carcinogenesis (LCR, E2, E5, E6, E7, L1, L2) to prioritize sequence variants for functional validation as biomarkers, using CaCx cases (n=74) and asymptomatic controls (n=24). Of the nucleotide variations recorded (n=271), non-synonymous changes in L2 region were significantly higher (p=0.005) among cases (2.67%) compared to controls (1.27%). Using SIFT database, 29 non-synonymous changes (frequency=0.01-0.03) predicted as deleterious to protein functions were identified. Haplotype analysis considering 110 polymorphic variations (frequency> or =0.05) within intact viral isolates (53 CaCx cases and 21 controls) using NETWORK software, confirmed Asian-American (AA, 14.86%) and European (E, 85.14%) variants, differing at 78 positions. The E-variants portrayed thirty-six haplotypes, of which, E-12 was most prevalent within cases (38.1%; 16/42) and controls (28.57%; 6/21) harboring polymorphic variations at 10 positions, in contrast to HPV16R.Cases of the E-12 haplotype harbored 7 deleterious mutations distributed within L1 (n=1), E2 (n=1), E5 (n=1), and L2 (n=4), while none within similar controls. Thus rare deleterious variations within genes implicated in productive infection over the E-12 haplotype background of intact HPV16 isolates might be of causal relevance for CaCx development. Language: English Keywords: INDIA | RESEARCH REPORT | HPV | CERVICAL CANCER | CASE STUDIES | UTERINE EFFECTS | GENETICS | Developing Countries | Asia, Southern | Asia | Viral Diseases | Diseases | Cancer | Neoplasms | Studies | Research Methodology | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 328367 |
| 16. Peer Reviewed Title: Contraceptive applications of progesterone receptor modulators. Author: Chabbert-Buffet N; Ouzounian S; Kairis AP; Bouchard P Source: European Journal of Contraception and Reproductive Health Care. 2008 Sep;13(3):222-30. Abstract: Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings. Language: English Keywords: BELGIUM | RESEARCH REPORT | WOMEN | PROGESTERONE | CONTRACEPTION | BLEEDING | UTERINE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | VAGINAL RING | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Methods Document Number: 329698 |
| 17. Peer Reviewed Title: Clinical effects of the levonorgestrel-releasing intrauterine device in patients with adenomyosis. Author: Cho S; Nam A; Kim HY; Chay DB; Park K Source: American Journal of Obstetrics and Gynecology. 2008 Apr;198(4):373.e1-373.e7. Abstract: The aim of this study was to evaluate the long-term clinical effects of a levonorgestrel-releasing intrauterine device (LNG-IUD) on adenomyosis. A LNG-IUD was inserted into 47 patients who were diagnosed with adenomyosis. Uterine volume, uterine artery blood flow, pictorial blood loss assessment chart (PBAC) scores, and the degree of dysmenorrhea were evaluated before and 36 months after insertion of the LNG-IUD. Pain scores and PBAC scores dropped dramatically in 6 months and showed significant decrease after 36 months. A significant decrease in mean uterine volume was noted 12 months (156.85 plus or minus 49.79 mL to 118.64 plus or minus 41.36 mL; P less than .001) and 24 months (128.84 plus or minus 48.70 mL; P less than .001) after LNG-IUD insertion, but no significant differences were noted at 36 months. The mean pulsatility indices of both uterine arteries increased significantly 12 months after insertion (P = .002 for right; P = .011 for left) and decreased after 24 months without significance. Uterine volume and uterine blood flow were negatively correlated (Pearson's correlation, P less than .05). Significant increase of uterine volume, pain scores, and PBAC scores were noted at 36 months compared with 12 months after insertion(P = .034, .021, and .001, respectively). For patients with clinical diagnosis of adenomyosis, the LNG-IUD is effective for the reduction of uterine volume with improvement of vascularity and relief of symptoms. However, the efficacy of LNG-IUD on uterine volume may begin to decrease 2 years after insertion. (author's) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | FAMILY PLANNING ACCEPTORS | ENDOMETRIOSIS | IUD, HORMONE RELEASING | LEVONORGESTREL | PAIN | UTERINE EFFECTS | SIGNS AND SYMPTOMS | Asia, Eastern | Asia | Developed Countries | Research Methodology | Demographic Factors | Population | Family Planning Programs | Family Planning | Diseases | IUD | Contraceptive Methods | Contraception | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 326112 |
| 18. Title: [Dysfunctional uterine bleeding--diagnostics and treatment] Czynnosciowe krwawienia maciczne--diagnostyka i leczenie. Author: Jakimiuk AJ; Grzybowski W; Beta J Source: Ginekologia Polska. 2008 Apr;79(4):254-8. Abstract: Dysfunctional uterine bleeding (DUB) occurs frequently in women at the reproductive age and is unrelated to structural uterine abnormalities. It significantly impairs the quality of life for many otherwise healthy women. Evaluation of patients with abnormal uterine bleeding and identification of those with DUB is based on medical records, physical examination, laboratory tests, uterine imaging and endometrial sampling. Surgical treatment options include hysterectomy and conservative surgery (endometrial resection or ablation). Medical therapy, with the avoidance of possibly unnecessary surgery, is an attractive treatment option. However, there is considerable variation in practice and lack of consensus regarding the most effective therapy. Language: Polish Keywords: BRAZIL | SUMMARY REPORT | WOMEN | BLEEDING | UTERINE EFFECTS | LABORATORY EXAMINATIONS AND DIAGNOSES | REPRODUCTIVE AGE | HYSTERECTOMY | ENDOMETRIAL EFFECTS | SURGERY | TREATMENT | Developing Countries | South America, Eastern | South America | Latin America | Americas | Demographic Factors | Population | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Gynecologic Surgery | Urogenital Surgery | Endometrium Document Number: 328920 |
| 19. Peer Reviewed Title: Uterine artery pseudoaneurysm manifesting delayed postabortal bleeding. Author: Kim YA; Han YH; Jun KC; Jeon MK; Lee ES Source: Fertility and Sterility. 2008 Sep;90(3):849.e11-4. Abstract: OBJECTIVE: To study a case of a huge pseudoaneurysm of the uterine artery presenting with vaginal bleeding 2 years after termination of pregnancy in a 23-year-old woman. DESIGN: Retrospective clinical case. SETTING: Academic-based gynecology center of university hospital. PATIENT(S): A 23-year-old women, 2 years after termination of pregnancy, presenting with vaginal bleeding. INTERVENTION(S): The diagnosis of uterine artery pseudoaneurysm was made by color and duplex Doppler ultrasonography and confirmed by arteriography. The angiographic study showed a pseudoaneurysm arising from the right uterine artery. MAIN OUTCOME MEASURE(S): Clinical response to treatment. RESULT(S): The uterine artery pseudoaneurysm was successfully treated by embolization. The vaginal bleeding subsided immediately after embolization. The patient was monitored monthly for 12 months, during which she had normal menstruation period and no further vaginal bleeding. CONCLUSION(S): Although likely not a common complication of abortion, the diagnosis should be considered in those patients with postabortive bleeding and cystic lesion in the pelvis on ultrasonography. Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | POSTABORTION | UTERINE EFFECTS | BLEEDING | TREATMENT | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Reproduction | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329061 |
| 20. Peer Reviewed Title: Goserelin versus leuprolide before hysterectomy for uterine fibroids. Author: Lim SS; Sockalingam JK; Tan PC Source: International Journal of Gynecology and Obstetrics. 2008 May;101(2):178-183. Abstract: The objective was to compare goserelin and leuprolide given before hysterectomy for symptomatic large fibroid uteri. A randomized study of 66 premenopausal women with fibroid uteri at least 14 weeks of gestation in a gravid uterus. Women were randomized to receive either subcutaneous depot 3.6 mg goserelin or 3.75 mg leuprolide every 4 weeks for a total of 3 doses. Hysterectomy was performed within 1 month of the last dose. A total of 34 women randomized to the goserelin group and 31 women to the leuprolide group were available for analysis. Preoperative hemoglobin level (P=0.89), operative blood loss (P=0.72), and operating time (P=0.39) were not different between the 2 groups. Postoperative hemoglobin was higher in the leuprolide group (P=0.003), but blood transfusion requirement was not different between the groups (P=1.0). Other outcomes and side effects of the drugs were similar. Goserelin and leuprolide administered before hysterectomy for uterine fibroids have similar perioperative outcomes. (author's) Language: English Keywords: MALAYSIA | RESEARCH REPORT | WOMEN | UTERINE EFFECTS | FIBROIDS | DRUGS | ADMINISTRATION AND DOSAGE | GONADOTROPINS | HYSTERECTOMY | HEMOGLOBIN LEVEL | SIDE EFFECTS | Developing Countries | Asia, Southeastern | Asia | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Neoplasms, Benign | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormones | Endocrine System | Gynecologic Surgery | Urogenital Surgery | Surgery | Hemic System Document Number: 325981 |
| 21. Peer Reviewed Title: Use of the levonorgestrel-releasing intrauterine system in women with hemostatic disorders. Author: Lukes AS; Reardon B; Arepally G Source: Fertility and Sterility. 2008 Sep;90(3):673-7. Abstract: OBJECTIVE: To evaluate the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) in women with known hemostatic disorders and abnormal uterine bleeding. DESIGN: Retrospective case series. SETTING: Tertiary medical center. PATIENT(S): Women with regular, heavy menstrual bleeding who have von Willebrand's disease and/or are receiving anticoagulation therapy for a thrombotic disorder. INTERVENTION(S): Levonorgestrel intrauterine system. MAIN OUTCOME MEASURE(S): Impact on menstrual bleeding and quality of life. RESULT(S): Seven women with hemostatic disorders who had used the LNG-IUS were identified. All 7 women completed the survey. Median age was 38 years (range 28-48 years). Six women were white, 1 woman was black. Four women had von Willebrand's disease. Four women were using anticoagulation, 3 warfarin, and 2 aspirin. One woman had both von Willebrand's disease and was heterozygous for factor V Leiden. All 7 women had heavy menstrual bleeding. After placement of the LNG-IUS, a decrease in number of bleeding days was seen in 71% of subjects (5 of 7), with overall median days reduced from 9 to 3 days. One subject discontinued use of the LNG-IUS because she desired pregnancy. Two subjects (29%) had no benefit from the LNG-IUS. Quality of life improved after placement of the LNG-IUS. CONCLUSION(S): The LNG-IUS seems to be an effective treatment for heavy menses in women with hemostatic disorders. Providers should consider this option for women with hemostatic disorders because it is safe and simple to use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | LEVONORGESTREL | IUD, HORMONE RELEASING | UTERINE EFFECTS | BLEEDING | CONTRACEPTIVE USE-EFFECTIVENESS | SAFETY | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | IUD | Contraceptive Methods | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Contraceptive Effectiveness | Public Health | Health Document Number: 329060 |
| 22. Title: [The pathogenesis of uterine hemorrhages in the so-called placental polyps] Author: Milovanov AP; Kirsanov IaN Source: Arkhiv Patologii. 2008 Jul-Aug;70(4):34-7. Abstract: On the basis of histological and immunohistochemical studies of 50 uterine scrapes after abortions and labor due to late bleedings, the authors identified three major types of the so-called placental polyps: (a) preserved villi (56%); (b) clusters of destructive villi (38%); (c) isolated viable cotyledons (6%). Two pathogenetic mechanisms of uterine hemorrhages have been substantiated: firstly, preservation of the brush border of a syncytiotrophoblast (including the presence of placental phosphatase) maintains the anticoagulative properties of villi; this appears in cases of postabortion hemorrhages and at the most in preserved cotyledons. Secondly, the thromboplastic properties of the preserved villi play a leading role in the pathogenesis of uterine hemorrhage in the scrapes where necrotic villi with epithelial remains are prevalent, i.e. the situation is similar to the hypocoagulative phase of isolated chronic disseminated intravascular coagulation. Language: Russian Keywords: RESEARCH REPORT | STUDIES | HISTOLOGY | WOMEN | UTERINE EFFECTS | BLEEDING | Research Methodology | Biology | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Signs and Symptoms | Diseases Document Number: 329025 |
| 23. Peer Reviewed Title: Selected metabolic parameters and the risk for uterine fibroids. Author: Sadlonova J; Kostal M; Smahelova A; Hendl J; Starkova J Source: International Journal of Gynecology and Obstetrics. 2008 Jul;102(1):50-54. Abstract: Objective: To analyze the possible association between insulin resistance and dyslipidemia with uterine fibroids, using objective metabolic measurements. Method: A cross-sectional study of 56 women with uterine fibroids (case group) and 20 women without fibroids (control group). Levels of fasting glucose, insulin, C-peptide, sex hormone-binding globulin, and the lipid panel were measured. The short insulin tolerance test was performed. Body mass index, atherogenic index, and the indicator of insulin resistance (Kitt) were also calculated. Results: Women with fibroids had significantly higher levels of serum HDL-cholesterol compared with control patients (1.8 +or- 0.3 vs 1.6 +or- 0.5; P<0.05). Women with fibroids aged 30-45 years had significantly lower LDL-cholesterol levels than comparative control patients (2.9 +or- 0.7 vs 3.4 +or- 0.9; P<0.05). A positive correlation between volume of the largest fibroid and serum HDL-cholesterol level was found in women aged 30-45 years. There were no differences in indicators of insulin resistance between the groups. Conclusion: Insulin resistance was not shown to be a risk factor for fibroids. There is a negative association between some parameters of metabolic syndrome and fibroid volume. (author's) Language: English Keywords: CZECH REPUBLIC | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | FIBROIDS | RISK FACTORS | DRUG RESISTANCE | CHOLESTEROL | METABOLIC EFFECTS | UTERINE EFFECTS | Developing Countries | Europe, Central | Europe | Research Methodology | Demographic Factors | Population | Neoplasms, Benign | Neoplasms | Diseases | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Physiology | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 327329 |
| 24. Peer Reviewed Title: Hysterosalpingographic findings in infertile women with genital tuberculosis. Author: Sharma JB; Pushparaj M; Roy KK; Neyaz Z; Gupta N Source: International Journal of Gynecology and Obstetrics. 2008 May;101(2):150-155. Abstract: The objectives were to evaluate the hysterosalpingographic findings from infertile women who were subsequently diagnosed with genital tuberculosis. A retrospective study of 70 infertile women who underwent hysterosalpingography to investigate infertility and were subsequently diagnosed with genital tuberculosis. The mean age of the women was 27.3 years and the mean duration of infertility was 6.1 years. A total of 57 (81.4%) women had primary infertility while 13 had secondary infertility. Diagnosis of genital tuberculosis was made by polymerase chain reaction (54.3%), tuberculous granuloma on biopsy (22.8%), acid-fast bacilli culture (2.8%), and at laparoscopy or hysteroscopy (20%). Hysterosalpingographic findings were a normal uterine cavity observed in 57.1% of women, an irregular cavity in 18.5%, a shrunken cavity in 2.8%, and an irregular filling defect in 18.5%. Synechiae were observed in 17.1% of women. Genital tuberculosis is a common cause of infertility in India, causing significant uterine and tubal pathologies. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | TUBERCULOSIS, FEMALE GENITAL | INFERTILITY | HYSTEROSALPINGOGRAPHY | UTERINE EFFECTS | TUBAL EFFECTS | ADHESIONS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Tuberculosis | Infections | Diseases | Reproduction | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Fallopian Tubes | Signs and Symptoms Document Number: 325978 |
| 25. Peer Reviewed Title: Interferon-gamma (IFN-gamma): A possible prognostic marker for clearance of high-risk human papillomavirus (HPV). Author: Song SH; Lee JK; Lee NW; Saw HS; Kang JS Source: Gynecologic Oncology. 2008 Mar;108(3):543-548. Abstract: The goal of this study was to identify cytokines that may predict high-risk HPV clearance or persistence in untreated patients with mild dysplasia or less of the uterine cervix. A prospective analysis was performed on 57 patients who harbored high-risk HPV with histologically verified mild dysplasia or less between May 2005 and March 2006. All patients underwent follow-up evaluation at 12 months. Real-time PCR was used to quantify interferon-gamma (IFN-y), interleukin-10 (IL-10), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) transcripts. Hybrid Capture II testing was used to detect HPV DNA. Among the 57 patients that were untreated with mild dysplasia, or less, 46 (80.7%) had no detectable HPV after 12 months of follow-up. Univariate analysis showed that a negative HPV test, of untreated mild dysplasia or less, occurred in 93.3% (28/30) of patients who were IFN-y-positive and in 66.7% (18/27) of patients who were IFN-gamma-negative (P=0.0109). Other factors such as age, lesion grade in the colposcopic biopsy, IL-10, IL-6, TNF-alpha, day of menstrual cycle, smoking, and use of oral contraceptives were not significantly associated with high-risk HPV negative or positive results after 12-months of follow-up in patients with untreated mild dysplasia or less. The multivariate logistic regression analysis showed that only IFN-gamma-positive results were significantly associated with clearance of high-risk HPV after 12 months of follow-up (OR: 8.26; 95% CI: 1.24-54.94). These results suggest that intralesional IFN-y may be a prognostic marker for clearance of high-risk HPV. (author's) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | LABORATORY PROCEDURES | PROTEINS | IMMUNITY, CELLULAR | RISK FACTORS | HPV | CERVIX | UTERINE EFFECTS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Immunity | Immune System | Viral Diseases | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 326847 |
| 26. Title: Non-surgical management of uterine fibroids. Author: Tropeano G; Amoroso S; Scambia G Source: Human Reproduction Update. 2008;14(3):259-274. Abstract: Efforts to develop alternatives to surgery for management of symptomatic uterine fibroids have provided new techniques and new medications. This review summarizes the existing literature on uterine artery embolization (UAE) and investigational studies on four newer approaches. PubMed, Cochrane and Embase were searched up to December 2007. Studies reporting side-effects and complications and presenting numerical data on at least one outcome measure were included. Case studies report 50-60% reduction in fibroid size and 85-95% relief of symptoms following UAE. The largest of these studies reported an in-hospital complication rate of 2.7% (90 of 3041 patients) and a post-discharge complication rate of 26% (710 of 2729 patients). Eight studies compared UAE with conventional surgery. Best evidence suggested that UAE offered shorter hospital stays (1-2 days UAE versus 5-5.8 days surgery, 3 randomized controlled trials (RCTs)) and recovery times (9.5-28 days UAE versus 36.2-63 days surgery, 3 RCTs) and similar major complication rates (2-15% UAE versus 2.7-20% surgery, 3 RCTs). Four studies analysing cost-effectiveness found UAE more cost-effective than surgery. There is insufficient evidence regarding fertility and pregnancy outcome after UAE. Five feasibility studies after transvaginal temporary uterine artery occlusion in 75 women showed a 40-50% reduction in fibroid volume and two early studies using magnetic resonance guided-focused ultrasound showed symptom relief at 6 months in 71% of 109 women. Two small RCTs assessing mifepristone and asoprisnil showed promising results. Good quality evidence supports the safety and effectiveness of UAE for women with symptomatic fibroids. The current available data are insufficient to routinely offer UAE to women who wish to preserve or enhance their fertility. Newer treatments are still investigational. (author's) Language: English Keywords: ITALY | LITERATURE REVIEW | WOMEN | UTERINE EFFECTS | FIBROIDS | TREATMENT | COMPLICATIONS | COST EFFECTIVENESS | PREGNANCY OUTCOMES | SAFETY | Europe, Southern | Europe | Developed Countries | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Neoplasms, Benign | Neoplasms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Pregnancy | Reproduction | Public Health Document Number: 326135 |
| 27. Title: Rupture of uterus in the first trimester during medical termination of pregnancy for exomphalos using mifepristone/misoprostol. Author: Willmott FJ; Scherf C; Ford SM; Lim K Source: BJOG. 2008 Nov;115(12):1575-7. Abstract: Medical termination is becoming an increasingly popular choice for women with unwanted pregnancies and their doctors. In 2006, the total number of abortions for women residing in England and Wales was 193 700 compared with 186 400 in 2005, a rise of 3.9%. Of these, medical abortions accounted for 30% of the total compared with 24% in 2005.1 The tendency towards medical abortions is increasing year on year. Uterine rupture is a recognised rare complication of medical termination, associated with previous uterine scarring in later trimester abortion. Misoprostol is currently unlicensed for this indication. Large randomised trials to compare the adverse events of medical and surgical termination have not been informative. However, as greater experience in medical terminations is gained, more complications are experienced. We would like to present this case, with the woman's consent, of a hitherto unreported first trimester complication of a misoprostol/mifepristone medical termination of pregnancy (MTOP). (excerpt) Language: English Keywords: UNITED KINGDOM | SUMMARY REPORT | CASE STUDIES | WOMEN | PREGNANCY, UNWANTED | UTERINE EFFECTS | BLEEDING | ABORTION | COMPLICATIONS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning Document Number: 330017 Notification |
28.  Peer Reviewed Title: Postmenopausal bleeding in patient with infantile uterus. Author: Anwar S; Shami N; Akmal I; Asif S Source: Pakistan Journal of Medical Sciences. 2007 Apr-Jun;23(2):290-292. Abstract: A 58 years old female patient married for 40 years, nulliparous, presented in outpatient department with the complaint of postmenopausal bleeding off and on for six months. Her total abdominal hysterectomy and bilateral salpingoopherectomy was performed. Uterus was small in size (infantile). Histopathology revealed endometrial hyperplasia with atypia. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CASE STUDIES | WOMEN | MIDDLE AGED ADULTS | NULLIPARITY | MENOPAUSE | BLEEDING | HYSTERECTOMY | OVARIECTOMY | UTERINE EFFECTS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Parity | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Signs and Symptoms | Diseases | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 315626 |
| 29. Peer Reviewed Title: Unique case of successful twin pregnancy after spontaneous conception in a patient with uterus bicornis unicollis. Author: Arora M; Gupta N; Neelam; Jindal S Source: Archives of Gynecology and Obstetrics. 2007 Aug;276(2):193-195. Abstract: Abnormal fusion of the mullerian ducts or failure of absorption of the septum causes varying degrees of congenital uterine malformation. Twin gestation in a case of bicornuate uterus is extremely rare. We are reporting this case because of its extremely rare presentation, where twins have managed to reach term after spontaneous conception. A 28-year-old second gravida, para one was initially diagnosed to have diamniotic dichorionic twins on ultrasound. At term, she was referred to us with severe preeclamptic toxaemia. On examination, she was found to have a bicornuate uterus with one fetus in each horn. Both siblings were successfully delivered by caesarean section. So far, only one similar case has been reported following in vitro fertilisation. Although poor reproductive performance has been documented in previous reports of bicornuate uterus with twin gestation, our patient managed to reach term with delivery of healthy siblings by caesarean section. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PREGNANT WOMEN | ULTRASONICS | MULTIPLE BIRTH | UTERUS | UTERINE EFFECTS | MANAGEMENT | CHILDBIRTH | CESAREAN SECTION | INFANT HEALTH | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Organization and Administration | Pregnancy Outcomes | Pregnancy | Obstetrical Surgery | Surgery | Treatment | Child Health Document Number: 318311 |
| 30. Peer Reviewed Title: Hematometra following uterine compression sutures. Author: Dadhwal V; Sumana G; Mittal S Source: International Journal of Gynecology and Obstetrics. 2007 Dec;99(3):255-256. Abstract: Postpartum hemorrhage (PPH) occurs in nearly 4% to 6% of deliveries and accounts for 25% of all maternal deaths. Hysterectomy has been the management option for PPH resistant to oxytocics and stepwise uterine devascularization. Uterine compression sutures, namely the B-Lynch, Hayman, and Cho sutures are newer conservative procedures that require less time and expertise. Though reported successful, problems following use are emerging. We report a case of PPH managed successfully with uterine compression sutures that later presented with hematometra. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | CASE STUDIES | POSTPARTUM WOMEN | CESAREAN SECTION | BLEEDING | UTERINE EFFECTS | GYNECOLOGIC SURGERY | HEMATOMA | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Puerperium | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Urogenital Surgery Document Number: 322140 |
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