جستجوی مقالات مرتبط با کلیدواژه « Uterus » در نشریات گروه « پزشکی »

Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage. In this single-blinded randomized clinical trial, a sample of 300 women with a singleton pregnancy, at 37 to 40 weeks gestation, who were scheduled for cesarean section, was divided into two groups of 150 participants. In the intervention group after placental delivery, the uterus was covered with cold saline-soaked surgical sponges at 0-4°C at the time of hysterotomy repair, and the control group received standard cesarean section. The volume of blood loss, the hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocin therapy, and the incidence of adverse effects were recorded. The bleeding volume and hemoglobin concentration reduction were significantly lower in the intervention group than in the control group (260.86± 150.25 Vs 214.35± 83.51, P<0.0001 and 1.24±0.75 Vs 1.54±0.92, P = 0.007 respectively). There were no statistically significant differences between the two groups in the frequency of need for additional uterotonic drugs. (18% vs. 21.33%, P = 0.475.) The use of uterine cooling during cesarean section reduced the volume of blood loss and the rate of decline in hemoglobin concentration.

Sodium metabisulfite (SMB) is a frequently utilized as food preservative. While it is generally acknowledged to be safe, there have been concerns regarding its potential impacts. This study aimed to investigate the effects of sodium metabisulfite on the hormonal levels, ovarian and uterine histology, and oxidative stress markers in female Wistar rats.

Twenty-four adolescent female Wistar rats were randomly allocated into four groups of siz rats each: Group 1 (control) received 0.5mL normal saline; Group 2 was given 100 mg/kg SMB; Group 3 received 300 mg/kg SMB; and Group 4 was administered 500 mg/kg SMB. The administration was done orally over 28 days, followed by euthanasia for tissue collection. Blood samples were collected to assess the serum follicle stimulating hormone (FSH) and luteinizing hormone (LH), while ovary and uterus tissue samples were harvested for malondialdehyde (MDA) assays and histopathology. For histopathology, we used haematoxylin and eosin and periodic acid schiff staining.

The administration of SMB at doses of 300 and 500mg/kg had a notable impact on the hormone levels, particularly FSH and LH. The SMB doses also resulted in disrupted histo-architecture and altered glycogen expression in ovaries and uteri, as observed by histological examinations. Furthermore, SMB at 500mg/kg led to a significant increase in the oxidative stress marker malondialdehyde.

The SMB treatment affected FSH and LH levels, influencing ovarian and uterine structures. Disrupted structure and raised oxidative stress imply reproductive health risks. Further research is needed, including the effects of SMB on glycogen and FSH status.

Congenital uterine abnormalities affect 1-10% of the general population and are caused by defective paramesonephric duct fusion or resorption during embryonic stages.

Uterine didelphys is an exceptionally rare Müllerian duct anomaly that, when incidentally discovered, can be profoundly disconcerting for attending clinicians, patients, and their families. In this case report, we described an instance of undiagnosed uterine didelphys in a pregnant woman who was admitted at 39 weeks and 4 days of amenorrhea for her third delivery, wherein the condition was coincidentally identified during an elective cesarean section, resulting in a favorable fetal outcome.

We presented the case of a 32-year-old gravida 4 para 3+0 patient who was admitted at 39 weeks and 4 days of amenorrhea and had a history of three prior cesarean deliveries. She underwent an elective cesarean section. A second nongravid uterus with an ipsilateral fallopian tube and ovary was incidentally observed intraoperatively. Furthermore, a contralateral fallopian tube without an ovary was noted within the same uterus. Subsequent exploration revealed that each uterus had one fallopian tube and ovary, and both uteri shared a single cervix.

Vigilant preoperative assessment of all women scheduled for surgery is imperative to prevent such disconcerting, avoidable occurrences.

Müllerian duct abnormalities (MDAs) are the most common congenital genital abnormalities in females and included defects ranging from minor anomalies such as bicornuate or septate uterus to major defects such as uterus aplasia (1)Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare müllerian anomaly characterized by uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. The syndrome is usually associated with non-specific symptoms such as progressive pelvic pain after the menarche, dysmenorrhea, and palpable mass in the vagina caused by hematocolpos and hematometra.

Case report:

A 15-year-old single patient was admitted with abdominal pain and a feeling of heaviness. On examination of the abdomen and rectum, he had a palpable tactile mass about 10 cm in diameter. Heterogeneously attached to the right side of the uterine body through a base. The size and appearance of the left ovary was normal, but the right ovary was not observed. In the appendix on the right, a complex mass 46 mm in diameter was presented, indicating the presence of a serrated uterine fibroid or ovarian mass. The uterus was normal. Because virgin MRI was performed on abdominal MRI with and without contrast, renal failure and 80x56 mm cystic lesion with several thin internal septa were found in the right appendix.

The rarity of Herlyn-Werner-Wunderlich syndrome(HWWS) results in complicated diagnostic and therapeutic procedures.  Appropriate imaging techniques and correct interpretation is an attempt for faster diagnosis and treatment to avoid complications such as endometriosis and adhesions caused by chronic infections, and infertility. For these cases that had low age, due to the lack of a kidney and also negative impact of multiple surgeries on fertility, it is better the first decision to be made as a group in a medical joint commission. By increasing the number of case reports in the future, the etiology, best diagnostic and treatment methods will be more identified.

According to Persian medicine (PM), the uterus is an important organ in women, responsible for purifying the blood and nourishing the fetus. Each organ has a specific temperament distinct from the whole-body temperament based on PM. Dystemperament occurs when body or organ Mizaj (Persian word for temperament) deviates from what is considered normal, resulting in malfunction. Many gynecological disorders described in PM and conventional medicine, including infertility, recurrent miscarriage, oligomenorrhea/amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence, and pelvic pain, are considered to be associated with uterine dystemperaments. Hence, proper management of such disorders requires precise diagnosis and treatment of uterine dystemperaments. Accordingly, this review study aimed to collect and categorize these symptoms from PM texts and other relevant articles.

In this study, we reviewed 10 well-known PM references, including Canon in Medicine (Al-Qanun Fi al-Teb), the Great Panacea (Exir-e A’zam), the Treasure of Kharazmshah (Zakhireh Kharazmshahi), the Perfect Book of the Art of Medicine (Kamel alSana’a al-Tebbiya), Akbari’s Medicine (Tebb-E-Akbari), Gharshi’s Commentary on Canon of Medicine (Sharh-e Qarshi bar Qanun), Commentary on Hippocrates’ Aphorisms (Sharh-e Fosul-e Boqraat), Summary of Experiences (Kholasa-tut Tajarob), Description of Signs and Symptoms (Sharh-e Asbab va Alamat), and Aghili’s Treatments (Mo’alejat-e Aghili). Moreover, Scopus, PubMed, Web of Science, SienceDirect, and Google Scholar databases were queried with the keywords ‘mizaj’, ‘temperament’, ‘uterus’, ‘uterine’, ‘cold/hot or warm’, and ‘dry/wet’, while Persian databases of Magiran, Iran Medex, and SID were searched using keywords ‘mizaj’, ‘rahem’, ‘garm’, ‘sard’, ‘tar’, and ‘khoshk’ to extract signs and symptoms associated with uterine temperament and dystemperament.

Five indicators were specified in the articles and PM sources for determining the temperament and dystemperament of the uterus as follows: 1) Menstrual blood characteristics (including amount, temperature, color, odor, flow rate, and consistency); 2) Uterine discharge characteristics (including amount, consistency, color, odor, and accompanied symptoms, especially burning and itching); 3) Fertility and pregnancy status (including infertility, abortion, etc.); 4. Other characteristics of the female reproductive system (including pubic hair, menarche age, sexual desire and quality of intercourse, and vaginal and cervical condition on vaginal examination); and 5) General symptoms (including the ten PM indicators of whole-body Mizaj).

PM sources have described the characteristics of uterine temperament and dystemperament in detail. These indices can be used for more effective diagnosis, treatment, and even prevention of gynecological diseases, as well as designing and validation of standard tools for determining uterine temperament and dystemperament.

Endometrial receptivity is crucial for embryo implantation, and excessive uterine contraction reduces success. Nifedipine which is a calcium channel blocker, could decrease uterine contraction and improve pregnancy outcomes.

This study aimed to assess the effect of Nifedipine before embryo transfer on the pregnancy outcome in women undergoing in vitro fertilization (IVF) in a tertiary center in Iran.

150 women who were candidates for IVF were randomly assigned into 2 groups: group 1 received 20 mg Nifedipine 30 min before embryo transfer, and group 2 received no intervention. Blood pressure of the participants was monitored every 10 min for 1 hr under the supervision of an anesthesiologist. Finally, implantation rate and chemical and clinical pregnancy rates were compared between groups.

At the end of the study, 140 participants were included in the final analyses. No significant difference was observed in clinical pregnancy rates between groups (20% vs. 22%, p = 0.51)

Nifedipine administration before embryo transfer does not improve the implantation and clinical pregnancy rates in women undergoing IVF.

Polycystic ovarian syndrome (PCOS) with anovulation, hyperandrogenism, ovarian and uterine histological changes, menstrual irregularities, etc. signs is an infertility type. It seems that melatonin and metformin can improve these abnormalities.

To evaluate the effects of melatonin and metformin on the ovary and uterus in PCOS-induced mice using stereological methods.

72 adult female BALB/c mice (8-wk-old, 20-30 gr) were randomly divided into control (distilled water, gavage), PCOS (90 µg/kg letrozole, gavage), PCOS+metformin (500 mg/kg, gavage), PCOS+melatonin (10 mg/kg, intraperitoneal injection), and PCOS+melatonin control (0.5% ethanol saline) groups (n = 12/each). Another PCOS group was kept for a month to ensure that PCOS features remained. Finally, a stereological evaluation of the uterus and ovary was carried out, and vaginal cytology and serum testosterone levels were assessed.

PCOS mice treated with metformin and melatonin had lower testosterone levels, body weight, and more regular estrus cycles than the PCOS group (p ≤ 0.001). A significant decrease in conglomerate and daughter gland numbers, and primary, secondary, atretic, and cystic follicles numbers with a significant increase in primordial and Graafian follicles, and corpus luteum numbers (p ≤ 0.001) was seen in these treated mice. Also, endometrial vessels' volume and length significantly increased, but ovarian, endometrial, myometrial, stromal, and glands volume, and endometrial and myometrial thickness dramatically declined (p ≤ 0.001).

It appears that metformin and melatonin could restore the PCOS phenotype including estrus cycle irregularity, high testosterone level, and ovarian and uterine micromorphology to the control levels. However, the 2 treatments had similar effects on the examined parameters.

Hydatid cyst is a parasitic infection transmitted by oral ingestion of Echinococcus granulosus eggs. Hydatid cyst of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We present an 8-yr-old girl with complaints of swelling of lower abdomen, pollakiuria and bilateral flank pain was brought to Emergency Department of Harran University, Turkey, in Jun 2019. The patient had simultaneous hydatid cysts of the liver, mesentery and uterus. We performed abdominal exploration and completely removed the inner germinal layer of cyst through an incision made in the anterior of the uterine fundus. Then, we applied total excision to the two cysts in the right and left colon mesentery. Finally, we performed partial cystectomy to the cyst in the liver, and we removed the cyst membrane totally. In endemic regions, hydatid cysts should be considered for the diagnosis of children with cystic mass lesions. Uterine-sparing approach should be kept in mind as an option, especially in young women. Early surgical treatment of large pelvic cysts that cause obstructive uropathy may prevent the progression of renal damage.

Uterine leiomyoma with hepatic vasculopathy, specifically non-cirrhotic portal fibrosis (NCPF), has hitherto been undescribed. NCPF is characterized by elevated portal pressure sans cirrhosis and has previously not been described in association with a gynecological pathology. We report the case of a female under evaluation for a heterogeneously enhancing intrauterine mass with multiple hepatic lesions with increased uptake of fluorodeoxyglucose on positron emission analysis. Fibroscan values were increased. Histopathologic evaluations revealed a leiomyoma with liver tissue showing tubercular granulomas, thin wispy fibrotic strands, and rounded portal tracts pointed to NCPF. No evidence of malignancy was seen. Metabolic imaging may be unreliable to distinguish between benign and malignant uterine pathology and granulomatous and malignant hepatic lesions. Elastography may also be ineffective in diagnosing the etiology of liver fibrosis. Histopathological analysis hence remains essential despite noninvasive tests. Further research is required on females afflicted with NCPF to exclude a hormonal link.

The differential diagnosis between uterine fibroid and adenomyosis is sometimes difficult; a precise diagnosis is required in women with infertility because of the different choice of treatments. Ultrasound elastography (UE) is a novel technique to evaluate the elasticity or the stiffness of the tissue of interest. The present study aims to compare UE shear wave velocity (SWV) among normal uterine myometrium, uterine fibroid, and adenomyosis, and assess the accuracy of shear wave elastography in the diagnosis of adenomyosis. This cross-sectional study recruited 25 subjects for each group (control, adenomyosis, and fibroid) from April 2019 to April 2020. Transvaginal UE using an Aplio 500 (Toshiba Medical Systems, Japan) with ultrasound mapping for point of tissue biopsy was performed for all subjects. The diagnosis was confirmed by histology. Masson’s trichrome staining for collagen was performed and quantified. The mean ± standard deviation (SD) for SWV was 3.44 ± 0.95 m/seconds (control group), 4.63 ± 1.45 m/seconds (adenomyosis group), and 4.53 ± 1.07 m/seconds (fibroid group). The mean SWV differed when comparing normal myometrium and adenomyosis after adjustments for age and endometrial pathology (P=0.019). The cut-off point of SWV at 3.465 m/seconds could differentiate adenomyosis from the normal uterus with an 80% sensitivity, 80% specificity, and an area under the curve (AUC) of 0.80 (95% confidence interval [CI]: 0.68-0.93) (P<0.001). No significant difference in SWV between the adenomyosis and fibroid groups was detected. Shear wave elastography could be an alternative tool to distinguish between normal myometrium and adenomyosis; however, it could not differentiate adenomyosis from uterine fibroid or uterine fibroid from normal myometrium.

Extragenital tumors uncommonly affect the female genital tract and usually involve the ovaries (75-80%), while the uterus can harbor metastases in the context of a widely disseminated disease. The primary tumors are most often located in the breast (35%) or gastrointestinal tract (38%). Metastases to the uterine body usually involve the myometrium whereas those exclusively involving the endometrium are rare.

We report the case of a 50-year-old woman with endometrial metastasis from a colonic adenocarcinoma 6 years after the initial presentation.

Metastatic colon tumors can histologically present as a primary disease in the endometrium if the pathologist has little awareness to consider metastasis. The clinical history of disseminated metastases, the lack of CK7 expression at immunohistochemistry, and positive results for CK20 and nuclear CDX2 are helpful clues to support the diagnosis of metastatic carcinoma of colorectal origin.

Honeysuckle (Lonicera japonica) is an ornamental flowering plant with numerous traditional medicinal uses. It has been claimed to have anti-spasmodic activities, but only limited studies have been done to support this. The objective of this research was to investigate anti-spasmodic effect of L. japonica flower extract on uterus contractions.

Hydroalcoholic extract was prepared using the maceration technique. In addition, chloroform and ethyl acetate fractions were prepared using a solvent in solvent fractionation technique. Essential oils were collected using the hydro-distillation technique. Rat isolated uterus was suspended in an organ bath and contracted with oxytocin, acetylcholine (ACh), KCl, or application of electrical field stimulation (EFS). The relaxant effects of the extract, its fractions, and nifedipine were examined on uterine contrition induced by the above-mentioned stimuli.

Nifedipine in a concentration-dependent manner inhibited uterine contraction induced by oxytocin, KCl, ACh, and EFS. L. japonica flower extract also exhibited an inhibitory effect on the isolated rat uterus. Comparison of the hydroalcoholic extract with its chloroform and ethyl acetate fractions showed that the chloroform fraction was the most potent and the ethyl acetate the weakest part of the plant with antispasmodic activity. The relaxant effect of essential oil had close similarities to that of chloroform extract.

Lipophilic compounds isolated by the chloroform partition of crude hydroalcoholic extract of L. japonica flower exhibited the most antispasmodic activity. Ethyl acetate partition of the same extract exhibited the least activity. Therefore, it can be concluded that the spasmolytic constituents of L. japonica flower reside in chloroform partitioning. The nonpolar essential oils may also have a contribution.

Herlyn-Werner-Wunderlich Syndrome (HWWs) is a rare variant of Mullerian duct anomalies. It is associated with a wide range of gynecological and obstetric complications, such as urinary incontinence, urinary retention, endometriosis, pelvic infection, pelvic pain and infertility.

We conducted the present study to investigate and manage HWWs with pelvic pain. The surgery was performed on the operative room of Imam Reza Hospital in April 2018.

The reported case is related to Herlyn-Werner-Wunderlich Syndrome, a rare congenital Mullerian duct anomaly, which it is not included in the current classification system of the Mullerian abnormalities of the American Fertility Association and is based on the typical pattern of caudal evolution towards cranial.