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DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Endometriosis may be associated with:Deposits in lower abdominal scars.Chocolate cysts.Fixed retroverted uterus.Stricture formation in the bowel.Haemothorax.
Embryo Transfer
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Mock embryo transfer can be performed prior to an IVF cycle or just before actual embryo transfer. This is done in order to establish if there are any potential difficulties that could be addressed in a timely manner in order to reduce uterine trauma and avoid the risk of depositing the embryo in a suboptimal location. Mock embryo transfer may help to assess variables such as uterine cavity position, measurement, ease of access, and choice of catheter. However, since uterine and cervical anatomy have a great degree of variability, findings during mock embryo transfer may not be relevant by the time of the actual procedure. A previous study demonstrated that almost half of patients who had retroverted uterus during mock assessment were found to have anteverted uterus by the time of the actual procedure [59] (Video 10.3). However, for patients with previous surgeries on the cervix (i.e., previous cone biopsy, trachelectomy), it is imperative to establish if access to the uterine cavity is possible at all. If the mock procedure reveals complete stenosis of the passage, this patient may benefit from examination under anesthesia and cervical dilation prior to an IVF cycle commencement.
Practice exam 6: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
The typical clinical features associated with endometriosis include severe dysmenorrhoea, deep dyspareunia, chronic pelvic pain, infertility, cyclical or perimenstrual symptoms and dyschezia. Signs include pelvic tenderness, a fixed retroverted uterus and tender uterosacral ligaments (6).
A method to protect the endometrium for microwave ablation treating types 1-3 uterine fibroids: a preliminary comparative study
Published in International Journal of Hyperthermia, 2023
Hong-Hui Su, Dong-Ming Guo, Pei-Shan Chen, Meng-Hong Cai, Yu-Xia Zhai, Zhe Chen, Wei-Jian Luo, Zhi-hui Lin, Wen-Bin Zheng
Patients in the study group were treated with percutaneous intrauterine instillation of chilled saline to protect the endometrium. All patients took laxatives one day before surgery to empty the intestinal contents and emptied the bladder before puncture. Applying pressure to the abdominal wall during puncture can push the intestinal tracts and omentum aside. This helps to puncture the uterus, even the retroverted uterus. Additionally, the retroverted uterus can be punctured in the direction from the cervix to the fundus. Before the ablation started, an 18 gauge puncture needle was percutaneously penetrated into the uterine cavity under the guidance of ultrasound, and the outer end of the needle was supplied with chilled saline for instillation under continuous pressure to protect the endometrium throughout the operation (Figure 1). The instilled normal saline was discharged from the uterine cavity through the vagina. A funnel-shaped drainage bag was placed at the perineum to avoid spillage and drain the water into a bucket. The puncture needle was removed immediately after the operation.
Endoscopic Treatment of Previous Cesarean Scar Defect in Women with Postmenstrual Bleeding: A Retrospective Cohort Study
Published in Journal of Investigative Surgery, 2021
Ning-Ning Zhang, Guang-Wei Wang, Qing Yang
The underlying causes for the development of PCSD during the healing process of the myometrium are not clearly understood. However, several theories have been proposed. A low incision through the cervical tissue, inadequate suturing of the lower segment of the myometrial wall, repeated cesarean sections, and retroposition of the uterus (may impair wound healing or cause inflammation) have been reported to play a role [12,16,21]. The current study showed that postmenstrual bleeding before treatment was positively associated with the length and width of PCSD, suggesting that the size of PCSD may be related to the severity of symptoms. Moreover, in the case of retroverted uterus, the PCSD has been noted to be deeper than anteverted uterus, suggesting that patients with uterus retroposition are more likely to develop PCSD following cesarean section. However, the associations between PCSD and cesarean section during labor as well as repeated cesarean sections could not be studied due to the small sample size. Future clinical studies should undertake this important evaluation.
Recurrent incarceration of the severely retroverted uterus with successful second-trimester reduction
Published in Journal of Obstetrics and Gynaecology, 2019
Alexandra Lackey, Prajwal Dara, Christine Burkhardt
This case is of particular interest because this patient’s two incarcerations were symptomatic and successfully reduced early in the second trimester. The previously reported cases are summarised in Table 1. Of the 118 articles screened, eight were regarding cases of recurrent uterine incarceration. Just as other cases attribute uterine incarceration to uterine anomalies, our patient was noted to have a severely retroverted uterus. Our presentation differs, however, in that our patient presented with urinary retention at 15 weeks followed by 14 weeks. Our case is also remarkable because the appropriate treatment allowed our patient to carry both foetuses to term. Although the first pregnancy was delivered by caesarean due to the breech presentation, an ability to deliver the recurrent incarceration vaginally has not been reported according to our literature search.