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Mechanisms of Resistance to PARP Inhibitor and Its Combination Therapy Strategies to Improve Sensitivity in Ovarian Cancer LI Bin, LIN Huan-huan, HAN Fei-fei, TIAN Mei-ling, DUAN Ai-hong, KE Xiao-ning Journal of International Obstetrics and Gynecology    2023, 50 (5): 563-567.   DOI: 10.12280/gjfckx.20230329 Abstract （827）   HTML （54）    PDF （728KB）（1241）       Knowledge map    Ovarian cancer is the most lethal gynecological malignancy. Poly (ADP-ribose) polymerase inhibitor (PARPi) impairs the repair of DNA single-stranded breaks through enzymatic inhibition and PARP "trapping". The synthetic lethal effect of PARPi in combination with tumor cells with a breast cancer-related gene (BRCA) deficiency or defective in homologous recombination repair (HRR) in ovarian cancer promoting its application in the maintenance therapy of ovarian cancer. However, resistance to PARPi is an obstacle to the long-term use of PARPi. A number of studies have described mechanisms of acquired resistance to PARPi, which include broadly HRR recovery, replication fork protection, reduced PARP "capture", and increased drug efflux. By targeting specific resistance mechanisms, the main combination therapeutic strategies currently being investigated include combining PARPi with anti-angiogenic agents, cell cycle checkpoint protein inhibitors, signalling pathway inhibitors, immunotherapy, epigenetic modifiers, etc. A combination therapy strategy of drugs has the potential to prevent and counteract PARPi resistance, thereby improving PARPi′s sensitivity and antitumor effects. Reference | Related Articles | Metrics

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Role of Anti- Müllerian Hormone in Pathogenesis, Diagnosis and Treatment of Polycystic Ovary Syndrome GAO Ya, LU Di, SONG Dian-rong Journal of International Obstetrics and Gynecology    2023, 50 (5): 540-544.   DOI: 10.12280/gjfckx.20230141 Abstract （702）   HTML （27）    PDF （718KB）（1125）       Knowledge map    Polycystic ovary syndrome (PCOS) is a relatively common female reproductive endocrine and metabolic disorder with complex etiology and pathogenesis. Recent studies have found that anti-Müllerian hormone (AMH) is an important factor affecting the pathophysiology of PCOS. AMH is closely related to follicular development, hyperandrogenism, hypothalamic-pituitary-ovarian axis and heredity. AMH can inhibit primordial follicle recruitment and small sinus follicle growth, and prevent premature ovarian failure. AMH also exacerbates follicular growth and development disorders by interacting with androgens. In addition, AMH can activate the discharge of gonadotropin-releasing hormone (GnRH) neurons and increases the secretion of luteinizing hormone (LH), which in turn leads to the increase of androgen production. Moreover, high AMH status in pregnant women with PCOS can lead to masculinization of female offspring and PCOS-like reproductive and neuroendocrine phenotypes in adulthood. At the same time, AMH may also be a new indicator for the diagnosis of PCOS, and the determination of AMH level can also reflect and predict the therapeutic effect of PCOS patients. Reference | Related Articles | Metrics

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Research Progress of Negative Emotion in Patients with Polycystic Ovary Syndrome XU Hui, XIE Xiu-zhen Journal of International Obstetrics and Gynecology    2023, 50 (5): 530-534.   DOI: 10.12280/gjfckx.20230179 Abstract （648）   HTML （42）    PDF （910KB）（1114）       Knowledge map    Polycystic ovary syndrome (PCOS) is a common reproductive endocrine syndrome in women of reproductive age. Many studies have pointed out that long-term negative emotions such as depression, anxiety, fear and tension are associated with PCOS. As an adjuvant therapy for PCOS, emotional intervention therapy can effectively improve patients′ conditions and quality of life, which has attracted much attention of scholars at home and abroad. This article has summarized the relevant studies on PCOS and negative emotions, and the possible mechanisms of negative emotions in the occurrence and development of PCOS, the influencing factors of negative emotions in PCOS patients, and the methods of emotional intervention therapy were discussed, in order to provide a basis for clinical medical staff to carry out psychological intervention for patients with PCOS. Reference | Related Articles | Metrics

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Effects of Negative Emotion on Infertility Patients with Polycystic Ovary Syndrome KOU Li-hui, SONG Dian-rong, GUO Jie Journal of International Obstetrics and Gynecology    2023, 50 (5): 535-539.   DOI: 10.12280/gjfckx.20230144 Abstract （659）   HTML （29）    PDF （741KB）（1100）       Knowledge map    Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine disease in women of reproductive age. It is affected by traditional Chinese culture, fertility concepts, social, economic, family and the disease, PCOS infertility patients often have impaired psychological regulation function, showing more obvious negative emotional characteristics such as depression and anxiety. Negative emotion and disease are causal to each other, they influence each other and form a vicious circle, affecting or aggravating the clinical features, sex hormone level and disorder of glucose and lipid metabolism of PCOS patients, which in turn leads to the occurrence of infertility, and the adverse effects of pregnancy outcomes. The positive psychological intervention and treatment can improve the patients′ psychological state, eliminate or alleviate the negative emotions such as anxiety, thus improve the treatment outcome of PCOS infertility. This article summarizing from the above aspects, is expected to provide new ideas for clinical treatment of patients with PCOS infertility. Reference | Related Articles | Metrics

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A Case of Ovarian Torsion and Necrosis after Ovarian Suspension Surgery PENG Hao-chen, SHAO Ya-wen, CAO Xiao-cui, SUN Jian-hao, WU Zhen-zhen Journal of International Obstetrics and Gynecology    2023, 50 (5): 559-562.   DOI: 10.12280/gjfckx.20230345 Abstract （755）   HTML （39）    PDF （3808KB）（1097）       Knowledge map    Ovarian suspension surgery can preserve ovarian function and improve quality of life in young patients with cervical cancer. In view of the fact that there is no unified standard surgical method at home and abroad, postoperative ovarian torsion, ovarian cyst and other related complications occasionally occur. A retrospective analysis was performed on a patient with stage cervical cancer admitted to Gansu Provincial Maternity and Child-Care Hospital in 2018. She underwent laparoscopic radical hysterectomy + bilateral ovary suspension surgery. She was re-admitted 3 years after the operation due to lower abdominal pain. The imaging assessment was recurrence and metastasis of cervical cancer. After discussion by multi-disciplinary team (MDT), laparotomy was performed to clarify the nature of the tumor. Postoperative pathological diagnosis was a case of ovarian torsion and necrosis. The selection of ovarian suspension location, intraoperative precautions, and postoperative complications were further analyzed in the light of the literature, in order to provide reference and experience in diagnosis and treatment for standardized surgical operations, early identification, and reasonable treatment of related complications. Table and Figures | Reference | Related Articles | Metrics

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Value of Patient-Reported Outcome Scale in Chemotherapy of Ovarian Cancer WANG Jian-zhang, RUAN Dan-hua, ZHAO Tian-lang, LIU Rui, ZHANG Xu-yang, ZENG Jing, YIN Ru-tie Journal of International Obstetrics and Gynecology    2023, 50 (5): 573-577.   DOI: 10.12280/gjfckx.20230338 Abstract （795）   HTML （23）    PDF （714KB）（1091）       Knowledge map    Ovarian cancer is the most lethal malignancy of the female reproductive system and the standard treatment of advanced ovarian cancer is cytoreductive surgery combined with chemotherapy and targeted therapy. Previously, patients′ adverse effects during and after chemotherapy were mainly assessed by Clinician-Reported Outcome (ClinRO). However, an emerging and reliable method of assessing patient health status Patient-Reported Outcome (PRO), has gained wide spread attention in clinical practice. Nowadays, commonly used PRO scales include PRO-Common Terminology Criteria for Adverse Events (CTCAE), M.D. Anderson Symptom Inventory (MDASI), QLQ-C30, etc., which can capable of multiple aspects of patient health status, detect clinical symptoms, intervene in clinical care and evaluate treatment options, and improve patient prognosis. However, the evaluation effect of some items in current PRO scales has not been effectively verified, and there is a lack of cohort studies for specific patient groups. Further improvement of the PRO scale and related studies is needed to achieve better results. Reference | Related Articles | Metrics

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A Simple Model Based on Fetal Head Circumference, Fetal Abdominal Circumference and Angle of Progression to Predict the Difficulty of Operative Vaginal Delivery CHEN Hui, WU Su-qing, LIANG Xu-xia, ZHANG Shan-shan, MA Yan-hua, HU Qiong-yan Journal of International Obstetrics and Gynecology    2023, 50 (5): 507-513.   DOI: 10.12280/gjfckx.20230209 Abstract （616）   HTML （57）    PDF （1412KB）（1091）       Knowledge map    Objective: To investigate the predictive value of joint use of fetal head circumference, fetal abdominal circumference and angle of progression (AOP) for the difficulty of operative vaginal delivery (forceps and vaccum). Methods: This prospective observational study was carried out in Department of Obstetrics of the People′s Hospital of Guangxi Zhuang Autonomous Region from May 2017 to July 2022. A total of 64 nulliparous women with singleton term pregnancies who required instrumentation to expedite vaginal delivery during the second stage of labor were included. Clinical data of pregnant women were collected after admission to the hospital. Fetal head circumference and fetal abdominal circumference were measured. Before performing operative vaginal delivery, AOP at rest and that during uterine contraction were measured by transperineal ultrasound (AOP1: mean of AOPs at rest, AOP2: mean of AOPs during uterine contraction). According to the outcomes of operative vaginal delivery, a case was included into "difficult or failed group" (Group A) when one or more of the following situations occurred: three or more tractions needed; successful operative vaginal delivery requiring sequential instruments (change vacuum to forceps); failed operative vaginal delivery; cesarean delivery due to a subjective impression of a difficult or failed traction; birth injury and the third- or the fourth-degree perineal tear. The rest cases were included into "successful and easy group" (Group B). Fetal head circumference, fetal abdominal circumference, AOP1 and AOP2 were used to establish four different predictive models by employing multivariable logistic regression. Receiver operator characteristic (ROC) curve was used to evaluate the discrimination of four models and the model with the largest area under ROC curve (AUC) was considered as the best one. Hosmer-Lemeshow test assessed the calibration of the optimal model. The optimal one was internally validated by using Bootstrap replicated sampling (1 000 times) method. Results: Statistically significant differences were revealed with regard to fetal head station by vaginal digital examination, duration of the last traction, initial direction of pulling in the last traction, fetal abdominal circumference, AOP1, AOP2, umbilical cord artery pH and rate of neonatal asphyxia (all P<0.05). A predictive model basing on the combination of fetal head circumference, fetal abdominal circumference, AOP1 and AOP2 showed the largest AUC (AUC=0.917, 95%CI: 0.821-0.972, Z=11.676, P<0.001). The Hosmer-Lemeshow test showed that χ2=5.873, P=0.661. Both of discrimination and calibration were good. The model showed good consistency in the internal validation. Conclusions: The simple model based on the combination of fetal head circumference, fetal abdominal circumference, AOP1 and AOP2 showed a predictive value for the difficulty of operative vaginal delivery and provided some basis for clinical decision-making. Table and Figures | Reference | Related Articles | Metrics

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Research Progress of Glucose Metabolic Reprogramming in Endometriosis LIU Jun-jun, ZHANG Ling, LIU Yi Journal of International Obstetrics and Gynecology    2023, 50 (5): 550-554.   DOI: 10.12280/gjfckx.20230228 Abstract （639）   HTML （32）    PDF （728KB）（1079）       Knowledge map    Glucose metabolic reprogramming is an important pathophysiological alteration during tumor development. Recent studies have revealed that endometriosis (EMs) has similar reprogramming of glucose metabolism to tumor, namely the transition from mitochondrial oxidative phosphorylation to aerobic glycolysis. Glucose metabolic reprogramming, characterized by increased glucose uptake, increased lactic acid production, and decreased production of reactive oxygen species, is closely associated not only with disease progression of EMs, but also with decreased oocyte quality and impaired endometrial receptivity in patients. This review systematically reviews the research progress of glucose metabolic reprogramming in EMs, providing deeper insight into the pathophysiological mechanism of EMs. Reference | Related Articles | Metrics

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The Combined Application of PARP Inhibitor and PD-1/PD-L1 Inhibitor in the Treatment of Ovarian Cancer GUO Jing-jing, ZHANG Yun-feng, WANG Yue Journal of International Obstetrics and Gynecology    2023, 50 (5): 568-572.   DOI: 10.12280/gjfckx.20230289 Abstract （808）   HTML （45）    PDF （736KB）（1079）       Knowledge map    Ovarian cancer is one of the three major gynecological malignancies and the most lethal malignancy of female reproductive system. At present, the main treatment methods for ovarian cancer are primary debulking surgery and platinum-based chemotherapy, but the recurrence rate and drug resistance rate remain high. In recent years, the development of tumor immunotherapy has progressed rapidly, especially the research on programmed death-1(PD-1) and programmed death-ligand 1 (PD-L1), which has been achieved on a variety of tumors. However, many clinical trials have found that PD-1/PD-L1 inhibitors alone are not effective in treating ovarian cancer. The poly (ADP-ribose) polymerase inhibitor (PARPi) is a type of targeted medicine that kills tumor cells through synthetic lethal effect. Recent studies have shown that PARPi has immunomodulatory effects in addition to its own cytotoxic effects, and can have a synergistic effect with PD-1/PD-L1 inhibitors, and the combination of the two can significantly improve patient prognosis. Therefore, this article reviews the research progress on the mechanism of action and clinical application of PD-1/PD-L1 inhibitor combined with PARPi in the treatment of ovarian cancer. Reference | Related Articles | Metrics

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Ultrasound Diagnosis of Intramural Ectopic Pregnancy: A Case Report ZHANG Chi, YAN Ying, LIANG Xue-mei, LI Jing-yu Journal of International Obstetrics and Gynecology    2023, 50 (5): 526-529.   DOI: 10.12280/gjfckx.20230312 Abstract （652）   HTML （58）    PDF （6011KB）（1077）       Knowledge map    Intramural ectopic pregnancy(IMP) currently lacks clear diagnostic and therapeutic criteria. When the diagnosis is not clear, it can lead to inappropriate treatment. Therefore, early diagnosis and correct treatment are particularly important, especially in view of preserving the patient′s future reproductive function. A case of IMP diagnosed by transvaginal gynecological color Doppler ultrasound was retrospectively analyzed. Hysteroscopy combined with laparoscopy and local injection were performed. The high risk factors, transvaginal ultrasound imaging manifestations and experience of hysteroscopy and laparoscopy in the treatment of IMP were analyzed and summarized in order to improve clinicians′ understanding of the disease and reduce the misdiagnosis and underdiagnosis of IMP in clinical practice. Transvaginal color Doppler ultrasound can early determine the size, location and relationship between the fetal sac and the muscle wall, which can be used as the first choice for early diagnosis of intramural pregnancy. Hysteroscopy combined with laparoscopy is a more effective method for further clarifying the diagnosis and treatment. Table and Figures | Reference | Related Articles | Metrics

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Study on the Role of Placental Mitochondrial Function in the Pathogenesis of Pregnancy Complications JI En-ting, XU Ya-xuan, ZHANG Chun-ren, HU Min, MA Hong-xia Journal of International Obstetrics and Gynecology    2023, 50 (5): 497-501.   DOI: 10.12280/gjfckx.20230425 Abstract （703）   HTML （58）    PDF （700KB）（1071）       Knowledge map    As the foundation for maintaining normal pregnancy and an important medium for maternal-fetal communication, the placenta can cause various pregnancy complications such as miscarriage, preeclampsia, gestational diabetes, and premature birth when it is in a state of fibrosis, hypoxia, chronic inflammation, insufficient blood supply, and other conditions. These complications can seriously affect women′s health and fetal outcomes. Mitochondria, as the hub of energy metabolism, can increase the level of inflammatory factors in placental tissue, disrupt the balance between oxidation and antioxidation, and resulting in placental functional damage when their dynamics, biosynthesis, oxidative phosphorylation, and other processes are abnormal, thereby promoting the occurrence and development of various pregnancy complications. This article reviews the current research on the impact of placental mitochondrial dysfunction on a variety of pregnancy complications and to explore the potential mechanisms involved. Reference | Related Articles | Metrics

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A Case of Growing Teratoma Syndrome Secondary to Ovarian Immature Teratoma and Literature Review WAN Tao, YU Ping-yuan, YANG Yong-xiu Journal of International Obstetrics and Gynecology    2023, 50 (5): 597-600.   DOI: 10.12280/gjfckx.20230385 Abstract （632）   HTML （42）    PDF （3834KB）（1068）       Knowledge map    Growing teratoma syndrome (GTS) is a rare disease that occurs in patients with immature teratoma (IMT) or mixed malignant germ cell tumors. Its characteristics are that during adjuvant chemotherapy or after chemotherapy after surgery treatment, the tumor markers are normal, the residual lesions of surgery are enlarged or other masses appear, and the postoperative pathological examination only shows mature teratoma tissue, without malignant germ cells. Complete surgical resection is the preferred option for the treatment for GTS, while immunoregulation, chemotherapy, and radiofrequency can stop the disease progression. The diagnosis of this disease is clear, but the incidence is low, and it is easy to be misdiagnosed as malignant tumor recurrence. A case of ovarian GTS after IMT is reported. Relevant literature is reviewed to improve the understanding of the disease, enrich clinical experience, and reduce misdiagnosis and underdiagnosis. Table and Figures | Reference | Related Articles | Metrics

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Clinical Effect of Xingnao Kaiqiao Acupuncture on Postpartum Depression WANG Qiang-yu, ZHANG Hai-yan, XIE An-ni, LI Xin-hua Journal of International Obstetrics and Gynecology    2023, 50 (5): 555-558.   DOI: 10.12280/gjfckx.20230208 Abstract （657）   HTML （24）    PDF （721KB）（1064）       Knowledge map    Objective: To investigate the effect of Xingnao Kaiqiao acupuncture on postpartum depression (PPD). Methods: A total of 80 patients with PPD in our hospital were selected from January 2022 to September 2022 and divided into two groups with 40 cases in each group by random number method. The control group was given conventional Western medicine, and the observation group was treated with acupuncture combined with Western medicine. The course of treatment was eight weeks. The therapeutic efficacy and safety of the two groups were analyzed, and the degree of depression [Hamilton Depression Scale (HAMD), Edinburgh Postpartum Depression Scale (EPDS)], sex hormone levels [progesterone (P), estradiol (E2)], neurotransmitter levels [5-hydroxytryptamine (5-HT), orphanin FQ (OFQ)] were compared between the two groups before treatment and eight weeks after treatment. Results: The efficacy of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). After eight weeks of treatment, the HAMD, EPDS scores and OFQ levels of the two groups decreased compared with those before treatment, and the observation group was lower than the control group; the P, E2 and 5-HT levels of the two groups increased compared with those before treatment, and the observation group was higher than the control group, and the difference was statistically significant (P<0.05). Conclusions: Xingnao Kaiqiao acupuncture has a significant effect on the treatment of PPD, which can improve the expression of depressed-related factors and reduce the degree of depression with high safety. Table and Figures | Reference | Related Articles | Metrics

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Effect of Uterine Microenvironment on Early Pregnancy in Patients with Recurrent Spontaneous Abortion LIN Kai-li, GUO Jie, ZHANG Wei, SONG Dian-rong, ZHANG Ji-wen, HUAI Qi-juan, ZHAO Lin Journal of International Obstetrics and Gynecology    2023, 50 (5): 502-506.   DOI: 10.12280/gjfckx.20230414 Abstract （636）   HTML （57）    PDF （3593KB）（1060）       Knowledge map    Objective: To investigate the effect of uterine microenvironment on early pregnancy in patients with recurrent spontaneous abortion (RSA). Methods: From October 2021 to January 2022, intrauterine lavage was collected from RSA patients who were admitted to our hospital for uterine clear operation and normal early pregnant women who were admitted for induced abortion during the same period. Concentrations of lipopolysaccharide (LPS), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2) and interferon-γ (IFN-γ) were detected. Endometrial cells and extravillous trophoblast cells were respectively interfered with intrauterine lavage to detect mRNA expression of TNF-α, IL-2, IFN-γ in endometrial cells and invasion and migration ability of extravillous trophoblast cells. Results: The concentrations of LPS, TNF-α, IL-2 and IFN-γ in intrauterine lavage of RSA patients were significantly higher than those of normal women in early pregnancy (P<0.05). The mRNA expressions of pro-inflammatory factors TNF-α, IL-2 and IFN-γ in endometrial cells of RSA patients were significantly increased after intrauterine lavage intervention compared with those of normal women in early pregnancy (P<0.05). After the intervention of intrauterine lavage with extravillous trophoblast cells in RSA patients, the number of invasive cells and migration area of cells were significantly decreased compared with that of normal women in early pregnancy (P<0.05). Conclusions: The uterine cavity of patients with RSA presents a microinflammatory state, which affects the invasion and migration ability of extravillous trophoblast cells and is not conducive to the maintenance of pregnancy. Table and Figures | Reference | Related Articles | Metrics

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Research Progress on the Application of Shock Index in Postpartum Hemorrhage QIN Shi-yi, SHAO Yong Journal of International Obstetrics and Gynecology    2023, 50 (5): 491-496.   DOI: 10.12280/gjfckx.20230253 Abstract （645）   HTML （68）    PDF （743KB）（1060）       Knowledge map    Postpartum hemorrhage is a common serious complication in obstetrics and the leading cause of maternal death worldwide. The key to reduce the incidence of its adverse outcomes lies in early and rapid identification and timely intervention. However, the clinical diagnostic criteria are mostly based on visual estimation of blood loss, and the severity of hemorrhage is likely to be underestimated, which can easily leads to delayed clinical diagnosis and treatment of postpartum hemorrhage. In recent years, a number of studies have proposed that shock index (SI) can alert hemodynamic instability and be used to predict the occurrence, development and adverse outcome of postpartum hemorrhage. Especially in areas with scarce medical resources, the application value of SI is greater. The relative delta-shock index (ΔSI) can further individualize the assessment of bleeding. SI as a predictor of postpartum hemorrhage has some limitations, but overall, its clinical value is worthy of recognizing. Reference | Related Articles | Metrics

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Complete Hydatidiform Mole with Co-Existing Fetus: A Case Report and Literature Review LI Jian, WANG Guan Journal of International Obstetrics and Gynecology    2023, 50 (5): 522-525.   DOI: 10.12280/gjfckx.20230567 Abstract （642）   HTML （71）    PDF （3687KB）（1048）       Knowledge map    Hydatidiform mole and co-existing fetus (HMCF) is a rare obstetric disease, including complete hydatidiform mole with co-existing fetus (CHMCF) and partial hydatidiform mole with a co-existing fetus (PHMCF). A case of CHMCF was reported by continuous monitoring of thyroid function, human chorionic gonadotropin and fetal status during pregnancy up to 37 weeks of gestation and delivery of a live infant by cesarean section. CHMCF is a clinically rare and high-risk disease. Therefore, pregnancy, parturition and postpartum follow-up should be carefully diagnosed and closely monitored through ultrasound, magnetic resonance imaging (MRI) and chromosomal karyotype analysis in institutions with prenatal diagnosis and gynecological oncology centers. Table and Figures | Reference | Related Articles | Metrics

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Angiomyomas of Vaginal Stump after Total Hysterectomy：A Case Report DING Yi, GAO Jun, LI Wen-yan, YE Dan, MA Zhen-qin, HE Rong-xia Journal of International Obstetrics and Gynecology    2023, 50 (5): 594-596.   DOI: 10.12280/gjfckx.20230533 Abstract （804）   HTML （39）    PDF （2246KB）（1037）       Knowledge map    Angioleiomyoma is a rare tumor of mesenchymal origin, mostly occurring in the lower extremities, rare in the female reproductive system, and vaginal stump angioleiomyoma is even more rare. This article reports a case of a patient with vaginal stump leiomyoma admitted to the Department of Gynecology of the Second Hospital of Lanzhou University. The patient underwent laparoscopic total hysterectomy in 2015 for uterine fibroids. She had vaginal bleeding for five months. In May 2023, she was admitted to the hospital for open surgery, during which it was found that the mass came from the vaginal stump. Pathology and immunohistochemistry suggested angioleiomyomas. Combined with this case, the literature review of female reproductive system angioleiomyoma mainly uterine angioleiomyoma was carried out to improve clinicians′ understanding and diagnosis and treatment of vascular smooth muscle tumors of the female reproductive system. Table and Figures | Reference | Related Articles | Metrics

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Advances in the Study of Fetal Intracranial Hemorrhage MA Shuai, XU Ying, WANG Min, LI Jie Journal of International Obstetrics and Gynecology    2023, 50 (5): 481-485.   DOI: 10.12280/gjfckx.20230234 Abstract （707）   HTML （118）    PDF （739KB）（1021）       Knowledge map    Fetal intracranial hemorrhage (FICH) is a rare clinical event of brain injury, mostly occurring in the middle and late stages of pregnancy. Because of the particularity of fetal brain structure, its pathogenesis may be related to the development of germinal layer, coagulation function and the autoregulation function of fetal intracranial vessels. FICH is often discovered by chance during routine pregnancy examinations, with atypical clinical manifestations and some patients progressing rapidly. There is no gold standard for FICH diagnosis, and the imaging manifestations are complex and varied. The diagnosis mainly relies on prenatal ultrasound and magnetic resonance imaging to assist, which needs to be distinguished from fetal intracranial tumors, Galen′s venous tumors, arachnoid cysts, and intracranial calcification. Depending on the location and extent of the hemorrhage, it can lead to varying degrees of neurological dysfunction and even death, with significant differences in prognosis. Summarize the research progress of FICH, aiming to deepen the understanding of the disease among clinical doctors, effectively improve clinical diagnosis and treatment capabilities, and reduce the birth rate of children with severe neurological sequelae while reducing the number of blindly induced abortions. Reference | Related Articles | Metrics

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Research Progress of Laparoscopic Uterine (Leiomyoma) Tissue Extraction Technology SHAO Si-qi, WU Zai-gui, CHEN Kai, RUAN Fei Journal of International Obstetrics and Gynecology    2023, 50 (5): 578-582.   DOI: 10.12280/gjfckx.20230297 Abstract （770）   HTML （31）    PDF （745KB）（1020）       Knowledge map    The techniques of uterine and uterine leiomyoma specimen tissue morcellation and extraction in gynecological surgery have been developed for decades, including electromechanical morcellation, transvaginal morcellation and small abdominal incision morcellation. In recent years, with the wide spread development of minimally invasive surgery such as laparoscopy, gynecologic surgeons have paid more and more attention to the tumor-free concept and tumor-free technology, and put forward higher requirements for the specimen morcellation and extraction technology. Different techniques have their own advantages and limitations, and there is no significant difference in the incidence of perioperative complications among them, but there are some limitations, such as the higher crushing rate of specimen bags by vaginal morcellation technique and the longer operation time by minilaparotomy morcellation technique. The practicability and safety of various technologies still need high-quality prospective clinical research to verify. When choosing the method of breaking and taking out specimens removal, the operator should strictly follow the principles of treatment and make individualized decisions so that patients can get a better prognosis. This paper reviews the research progress of large uterine (leiomyoma) tissue morcellation and extraction technology for clinical reference. Reference | Related Articles | Metrics

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Clinical Analysis of 33 Cases of Diffuse Uterine Leiomyomatosis XU Qian, CHENG Jiu-mei Journal of International Obstetrics and Gynecology    2023, 50 (5): 583-587.   DOI: 10.12280/gjfckx.20230317 Abstract （849）   HTML （42）    PDF （729KB）（1019）       Knowledge map    Objective: To improve the diagnosis and treatment of diffuse uterine leiomyomatosis (DUL). Methods: 33 cases of DUL admitted between January 2009 and October 2022 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively, including their clinical characteristics, diagnosis and treatment methods and postoperative pregnancy. Results: The average age of onset of the 33 patients was (38.4±6.9) years (24-52 years). Nineteen patients (57.6%) presented with menorrhagia, 7 patients (21.2%) presented with frequent urination or lower abdominal distension, and the remaining 7 patients (21.2%) were asymptomatic and the examination revealed the uterine leiomyoma was progressively enlarged. Ultrasound examination was performed in 33 patients, and 15 patients(45.5%) showed myometrium was full of hypoechoic nodules. 7 patients underwent magnetic resonance imaging (MRI), and 3 cases showed diffuse distribution of round nodules or masses of variable sizes in the myometrium. All 33 patients underwent surgical treatment, 19 underwent transabdominal or laparoscopic hysterectomy, the other 14 with fertility requirements, 11 of them underwent transabdominal myomectomy and 3 underwent hysteroscopic myomectomy. Postoperative pathology and immunohistochemistry were all suggestive of leiomyoma. The average follow-up time after surgery was (67.8±36.3) months in 14 patients with fertility requirements (2 patients lost). Three patients had natural pregnancies, two had successful deliveries (one of which had two deliveries), and the other had cornual pregnancy that was cleared. Conclusions: DUL is a rare benign smooth muscle tumor that occurs in women of reproductive age. The most common clinical symptoms were menorrhagia and infertility. If ultrasound shows myometrium was full of myoma nodules and the patient presents with menorrhagia or infertility except for other reasons, MRI is indicated to help identify the disease early stage. Surgery is the main treatment. Hysterectomy is recommended for patients without fertility requirements, and the choice of fertility-preserving treatment requires further research. Reference | Related Articles | Metrics