The latest medical research on Obstetrics And Gynecology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about obstetrics and gynecology gathered by our medical AI research bot.

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Robotic-assisted navigated minimally invasive pedicle screw placement in the first 100 cases at a single institution.

Journal of Robotic Surgery

Proper pedicle screw placement is an integral part of spine fusion requiring expertly trained spine surgeons. Advances in medical imaging guidance ...

Ensuring navigation integrity using robotics in spine surgery.

Journal of Robotic Surgery

There are potential pitfalls associated with the pursuit of accurate surgical navigation, such as vulnerability of the reference array to accidenta...

Robotic choledochoduodenostomy for benign distal common bile duct stricture: how we do it.

Journal of Robotic Surgery

Benign bile duct stricture poses a significant challenge for gastroenterologists and general surgeons due to the inherent nature of the disease, di...

Evaluation of a new robotic-assisted laparoscopic surgical system for procedures in small cavities.

Journal of Robotic Surgery

No data exists concerning the application of a new robotic system with 3-mm instruments (Senhanceâ„¢, Transenterix, Milano, Italy) in small cavities....

Pre-operative factors that predict trifecta and pentafecta in robotic assisted partial nephrectomy.

Journal of Robotic Surgery

To prospectively evaluate factors that predict achievement of trifecta and pentafecta following robotic-assisted partial nephrectomy (RAPN). Clinic...

The role of maternal T cell and macrophage activation in preterm birth: Cause or consequence?

Placenta

The role of the immune system in term (TL) and preterm labor (PTL) is unknown. Despite the fact that globally, PTL remains the most important cause...

Performance of middle cerebral artery peak systolic velocity for the prediction of fetal anemia in untransfused and transfused fetuses: a diagnostic test accuracy meta-analysis.

Ultrasound in Obstetrics and Gynecology

To evaluate the performance of Doppler studies using the middle cerebral artery peak systolic velocity (MCA-PSV) for the prediction of moderate-severe fetal anemia, in untransfused and transfused fetuses.

A systematic search was performed to identify relevant observational studies evaluating the performance of MCA-PSV using a 1.5 MoM threshold for the prediction of fetal anemia reported in the 2008-2018 period. The reference standard was the diagnosis of fetal anemia by blood sampling. A hierarchical summary receiver-operating characteristic curve (hSROC) was constructed using random effects modeling. Subgroup and meta-regression analyses according to the number of previous transfusions, were performed.

A total of 12 studies and 696 fetuses were included. The area under the curve (AUC) for moderate-severe anemia was 83%. Pooled sensitivity, specificity, positive and negative likelihood ratios were 79% (70%-85%), 73% (62%-82%), 3.0 (2.22-4.01), and 0.29 (0.21-0.38), respectively. If only untransfused fetuses are considered, prediction improves achieving an 87% AUC, 86% (75%-93%) sensitivity, and 71% (49%-87%) specificity. A decline in sensitivity is observed (estimate -0.055; 95% CI: -0.107 to -0.003; p=0.039) as more transfusions are required.

A moderate accuracy in the prediction of fetal anemia (86% sensitivity and 71% specificity) is demonstrated by Doppler assessment of MCA-PSV in untransfused fetuses that decline with an increasing number of intrauterine transfusions. This article is protected by copyright. All rights reserved.

The effect of morphological types of extrauterine ectopic pregnancies on the accuracy of pre-operative ultrasound diagnosis.

Ultrasound in Obstetrics and Gynecology

The aim of this study was to assess the overall accuracy of the transvaginal ultrasound scan (TVS) diagnosis of all types of extrauterine ectopic pregnancy (EUEP) in a large group of women who were managed surgically. We also examined the positive predictive value (PPV) of the different ultrasound morphological types of EUEP, using visual confirmation of ectopic pregnancy on surgery as the reference standard.

We performed a retrospective observational study of all pregnant women who underwent emergency surgery following ultrasound diagnosis of EUEP in a single Early Pregnancy Unit between January 2009 and December 2017. The pre-operative TVS findings were recorded including the exact location and morphological type (defined on ultrasound criteria, as type I-V) of EUEP. The TVS findings were compared with the operative and histological findings.

A total of 26401 women presented with early pregnancy complications during the study period, including 1241 (4.7%, 95% CI 4.5-5.0) women who were diagnosed with an EUEP. Surgery was performed in 721 cases (58.1%, 95% CI 55.3-60.8) out of which 710 (98.5%, 95%CI 97.6% to 99.4%) had been diagnosed with an EUEP on a preoperative TVS. The remaining 11 women had severe pain and significant haemoperitoneum and were managed surgically on clinical grounds as an emergency, without an ectopic pregnancy having been identified on ultrasound scan. At laparoscopy the diagnosis of EUEP was confirmed in 706/710 (99.4%, 95% CI 98.6-99.8) of women with positive ultrasound diagnosis and in all 11 women with presumed ultrasound diagnosis of EUEP. The PPV of pre-operative ultrasound for the diagnosis of EUEP was 99.4% (95% CI 98.6-99.8) with a sensitivity of 98.5% (95% CI 97.3-99.1). There was no statistically significant difference in the accuracy of pre-operative ultrasound diagnosis for the five morphological types of EUEP (p=0.76).

The accuracy of pre-operative ultrasound diagnosis of EUEP is high. The morphological type of EUEP on TVS had no significant effect on the accuracy of pre-operative diagnosis. This article is protected by copyright. All rights reserved.

Late stage Cesareans cause recurrent, early preterm birth: how to tackle this problem?

Ultrasound in Obstetrics and Gynecology

Preterm deliveries have multiple aetiologies and management is dependent on cause. Recent studies have shown that caesarean sections performed late...

Imaging of gynecological disease: clinical and ultrasound characteristics of serous cystadenofibromas in the adnexa.

Ultrasound in Obstetrics and Gynecology

To describe the clinical and ultrasound characteristics of serous cystadenofibromas in the adnexa.

This is a retrospective study. From the International ovarian tumor analysis (IOTA) database we identified patients with a histological diagnosis of serous cystadenofibroma, who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2012. In the IOTA database containing prospectively collected data, the tumors were described using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, three authors reviewed, first independently and then together, ultrasound images of serous cystadenofibromas and described them using pattern recognition.

We identified 233 women with a histological diagnosis of serous cystadenofibroma. In the IOTA database, most (67.4%) were described as containing solid components (157/233) but 19.3% (45/233) were described as multilocular cysts and 13.3% (31/233) as unilocular cysts. Papillary projections were described in 52.4% (122/233) of the cystadenofibromas. In 79.5% (97/122) of the cysts with papillary projections color Doppler signals were absent in the papillary projections. Most cystadenofibromas (83.7%, 195/233) manifested no or minimal color Doppler signals. On retrospective analysis of 201 ultrasound images of serous cystadenofibromas using pattern recognition we identified 10 major types of ultrasound appearance. The most common pattern was a unilocular solid cyst with one or more papillary projections (25.9%, 52/201). The second most common pattern was a multilocular solid mass with small solid component(s) but no papillary projections (19.4%, 39/201). The third and fourth most common patterns were multilocular cyst (16.9%, 34/201) and unilocular cyst (11.9%, 24/201). Using pattern recognition, shadowing was identified in 39.8% (80/201) of the tumors, and microcystic appearance of the papillary projections was observed in 35 (39.8%) of the 88 tumors containing papillary projections.

The ultrasound features of serous cystadenofibromas vary. The most common pattern is a unilocular solid cyst with one or more papillary projections with absent color Doppler signals. Most serous cystadenofibromas are poorly vascularized on color Doppler and many manifest acoustic shadowing. This article is protected by copyright. All rights reserved.

Fetal costello syndrome: a description of the phenotype of HRAS exon 1 mutations.

Ultrasound in Obstetrics and Gynecology

This is a description of similar prenatal ultrasound findings in five cases of fetal Costello syndrome from 3 countries. We suggest that Costello s...

Maternal and neonatal complications of fetal macrosomia.

Ultrasound in Obstetrics and Gynecology

To estimate risks of maternal and neonatal complications in pregnancies with macrosomia.

This was a retrospective cohort study undertaken at a large maternity unit in United Kingdom between January 2009-December 2016. We compared the incidence of complications in pregnancies with macrosomia, defined by birthweight (BW)>4,000 g and severe macrosomia with BW>4,500 g, to those in pregnancies with normal BW 2,500-4,000 g. Regression analysis was undertaken to determine odds ratios (OR) [95% confidence interval (CI)] for pregnancy complications in macrosomic compared to normal BW group.

The study population of 35,548 pregnancies included 4,522 (12.7%) with macrosomia, 643 (1.8%) with severe macrosomia and 31,026 (87.3%) with normal BW. In macrosomia group, adjusted OR was 3.07 (95%CI:1.64,2.01) for cesarean section for failure to progress, 2.40 (95%CI:1.95,2.96) for post-partum haemorrhage, 2.29 (95%CI:1.86,2.82) for sphincter injury, 10.37 (95%CI:8.57,12.55) for shoulder dystocia, 28.48 (95%CI:8.94,90.67) for brachial plexus injury, 32.33 (95%CI:3.76,278.15) for birth fractures and 4.40 (95%CI:2.20,8.82) for hypoxic-ischemic encephalopathy. The respective values for severe macrosomia were 4.32 (95%CI:3.05,6.13), 2.93 (95%CI:1.93,4.44), 3.12 (95%CI:1.92,5.08), 28.74 (95%CI:20.75,39.79), 73.92 (95%CI:15.05,363.16), 87.17 (95%CI:7.72,984.96) and 13.77 (95%CI: 5.16,36.75).

Macrosomia is associated with serious adverse perinatal outcomes. This study provides accurate estimates of risks to aid in pregnancy management. This article is protected by copyright. All rights reserved.