Impact of definitive uterine artery occlusion on ovarian reserve markers in laparoscopic myomectomy: a randomized controlled trial with 2-year follow-up

Human Reproduction, Год журнала: 2025, Номер unknown

Опубликована: Май 26, 2025

Abstract STUDY QUESTION Does definitive occlusion of uterine arteries have a short- or long-term impact on ovarian reserve markers in reproductive-age women undergoing laparoscopic myomectomy? SUMMARY ANSWER Preventive artery (UAO) during myomectomy reduces intraoperative blood loss but does not serum AMH levels after and follow-up women. WHAT IS KNOWN ALREADY Uterine leiomyomas are the most common benign tumours reproductive age. For symptomatic willing to retain their uterus, especially for future pregnancy, current gold standard is surgical subserous/intramural leiomyoma. Temporary can be performed control bleeding surgery its still unclear. A single randomized trial with 1-year demonstrated that temporary bilateral UAO slightly decreased at postoperative day 2 has no significant 3, 6, 12 months surgery. DESIGN, SIZE, DURATION We conducted controlled 2-year evaluating effect via sequential measures AFC by ultrasound assessment. The study included 58 leiomyoma type FIGO 3 6 scheduled between July 2015 October 2021. Patient allocation was disclosed surgeon just before starting procedure; were blinded group throughout study. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients two groups: (laparoscopic preventive arteries) (n = 29 women) no-UAO without intra-myometrial injection vasoconstrictive agents) (N women). Serum evaluated baseline (T0) followed 1 month (T1), (T3), (T6), (T12), 24 (T24) Intraoperative loss, evolution pain symptoms, recurrence also as secondary outcomes. Pregnancies live births monitored. MAIN RESULTS AND THE ROLE OF CHANCE Women both groups did differ characteristics terms age, body mass index, ethnicity, parity, wish become pregnant, hormonal treatment, number size, haemoglobin levels, AFC. mean operative time similar groups. Mean average 138 (±104) ml versus 436 (±498) controls (P < 0.001). In group, 0% had an >500 32.1% 0.01). Regarding clinical patients menstrual flow last visit (24 months) compared improvement dysmenorrhea same trend reduction risk any (T1, T3, T6, T12, T24) non-inferiority margin [−3.5 pmol/l]. Differences means 95% CI (in parentheses) follows: T1 −0.11 (−2.14 2.40), T3 −0.25 (−2.36 2.21), T6 0.81 (−2.69 3.84), T12 −0.95 (−3.15 1.33), T24 1.18 (−1.95 3.82). time, however, could demonstrated, presumably due large variability this measurement. LIMITATIONS, REASONS FOR CAUTION Our sample size calculated detect clinically relevant difference least two-thirds SD we cannot exclude larger might revealed smaller AMH. WIDER IMPLICATIONS FINDINGS compromise used safely improve perioperative Incorporating measure may enhance safety procedure. FUNDING/COMPETING INTEREST(S) Funded Department Paediatrics, Gynecology Obstetrics Geneva University Hospitals. There competing interests declare. TRIAL REGISTRATION NUMBER NCT02563392. DATE 9 2015. FIRST PATIENT’S ENROLMENT

Язык: Английский

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Evidence gaps for the global problem of iron deficiency and iron deficiency anemia in women and girls of reproductive age

International Journal of Gynecology & Obstetrics, Год журнала: 2023, Номер 162(S2), С. 89 - 92

Опубликована: Авг. 1, 2023

Abstract The symptom of heavy menstrual bleeding and the frequently associated condition iron deficiency (ID) individually collectively adversely impact lives women girls reproductive age in various ways. insidious but sometimes profound effects periconceptual ID on developing fetus may continue throughout individual's life with consequences that are also felt by families, friends, society at large. Unfortunately, most instances, current healthcare policies not designed to address plethora issues a fashion will result meaningful improvement health other outcomes affect both individuals society. Identification prioritization many evidence gaps be an essential component strategy for change. This article identifies describes provides direction investigators those involved policy.

Язык: Английский

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Expected treatment for endometrial polyp

Taiwanese Journal of Obstetrics and Gynecology, Год журнала: 2024, Номер 63(1), С. 1 - 3

Опубликована: Янв. 1, 2024

Язык: Английский

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Breaking Boundaries in Diagnosis: Non-Invasive Anemia Detection Empowered by AI

IEEE Access, Год журнала: 2024, Номер 12, С. 9292 - 9307

Опубликована: Янв. 1, 2024

This article evolved because several instances of anemia are still discovered too late, especially in communities with limited medical resources and access to laboratory tests. Invasive diagnostic technologies expensive expenses additional impediments early diagnosis. To detect anemia, an effective, accurate, non-invasive method is required. In this study, the conjunctival image eye analyzed as a detecting anemia. Various model approaches were tested endeavor categorize anemic healthy patients accurately possible. The Support Vector Machine (SVM) algorithm-integrated MobileNetV2 was determined be most effective plan. With combination, accuracy 93%, sensitivity 91%, specificity 94%. These findings show that can successfully identify while identifying patients. offers means on, making it promising for use clinical settings. SVM+MobileNetV2 technique relies on images conjunctiva has potential improve healthcare by people who may have had earlier. stands out solid option efficient precise diagnosis when accuracy, sensitivity, balanced.

Язык: Английский

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Effect of norethisterone dose and duration in the management of abnormal uterine bleeding: a narrative review and case report

Drugs in Context, Год журнала: 2024, Номер 13, С. 1 - 19

Опубликована: Июль 2, 2024

Abnormal uterine bleeding (AUB) is an acute/chronic variation in the normal menstrual cycle that affects adolescents, women of reproductive age and perimenopausal women. AUB approximately 3-30% reproductive-aged worldwide, reduces their quality life productivity whilst increasing overall healthcare burden. Its management requires thorough medical evaluation individualized treatment. Depending on severity cause AUB, its treatment ranges from lifestyle modifications hormonal therapies to more invasive procedures or surgery. Although therapy preferred first-line measure available pharmacological options have various adverse effects. There exists a need for safer efficient regimens with high patient compliance effectively treat AUB. Norethisterone, also known as norethindrone, widely used synthetic analogue progestogen. Controlled release formulations norethisterone/ norethisterone acetate help maintain constant drug levels blood exert minimal side-effects; therefore, they are promising therapeutic agents effective management. The present review summarizes epidemiology diagnosis focus safety, efficacy tolerability We report case 40-year-old woman, who was treated NETA tablets. resulted favourable outcomes, satisfaction.

Язык: Английский

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Management of Abnormal Uterine Bleeding Among Reproductive Age Group Women: A Cross-Sectional Study

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(23), С. 7086 - 7086

Опубликована: Ноя. 23, 2024

Abnormal uterine bleeding (AUB) is a common gynecological complaint affecting women of reproductive age. This study aimed to explore the management AUB using FIGO PALM-COEIN classification system.

Язык: Английский

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Advancements in Minimally Invasive Techniques and Biomarkers for the Early Detection of Endometrial Cancer: A Comprehensive Review of Novel Diagnostic Approaches and Clinical Implications

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(24), С. 7538 - 7538

Опубликована: Дек. 11, 2024

This review evaluates the advances in early detection and diagnosis of endometrial cancer (EC), emphasizing growing importance minimally invasive techniques novel biomarkers. Current diagnostic protocols for EC rely heavily on procedures such as transvaginal ultrasound (TVU), hysteroscopy, biopsy, which, although effective, can be overly burdensome patients inefficient asymptomatic or low-risk populations. As there is no consensus screening high-risk general populations, recent studies have explored alternative methods using biofluids genomic biomarkers to improve sensitivity specificity facilitate access patients. summarizes findings DNA methylation markers, circulating tumor-derived nucleic acids, potential liquid biopsy approaches EC. These innovations may not only streamline but also reduce need procedures. highlights these integrated seamlessly into existing cervical programs, which could transform support development personalized, less

Язык: Английский

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Evolving paradigms in the diagnosis and management of premenopausal women with abnormal uterine bleeding

The European Research Journal, Год журнала: 2024, Номер 10(4), С. 414 - 425

Опубликована: Июнь 27, 2024

Abnormal uterine bleeding (AUB) is a common gynecological complaint among premenopausal women, encompassing wide range of underlying disorders that complicate diagnosis and management. The evolving paradigms in medical science now incorporate advanced imaging techniques, personalized medicine, molecular diagnostics to improve the accuracy diagnoses effectiveness treatment plans. This review examines recent advancements diagnostic approach, including use transvaginal ultrasonography, hysteroscopy, biomarker analysis, which have significantly refined identification endometrial pathologies. Furthermore, we discuss shift towards individualized strategies consider patient-specific factors such as age, reproductive plans, comorbidities, facilitating tailored therapies. Special attention given role therapies ranging from hormonal treatments novel non-hormonal drugs, well consideration minimally invasive surgical options part comprehensive management strategy. By integrating current research findings with clinical practice guidelines, this article aims provide synthesized view dynamic field AUB management, proposing multidisciplinary approach enhance patient outcomes women.

Язык: Английский

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Conservative treatment for retained gestational tissue following miscarriage or abortion

Taiwanese Journal of Obstetrics and Gynecology, Год журнала: 2024, Номер 63(1), С. 8 - 9

Опубликована: Янв. 1, 2024

Язык: Английский

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Heavy uterine bleeding in women with endometriosis and adenomyosis treated with dienogest

Taiwanese Journal of Obstetrics and Gynecology, Год журнала: 2024, Номер 63(2), С. 139 - 140

Опубликована: Март 1, 2024

Язык: Английский

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