Perinatal and maternal mortality in a religious group avoiding obstetric care

We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a perinatal mortality rate three times higher and a maternal mortality rate about 100 times higher than the statewide rates. These findings suggest that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death.     

Leiomyosarcoma of the vulva

Leiomyosarcoma of the vulva is a rare disease and 15 cases only have been reported in the literature. On account of this rarity, we report a case that we had the opportunity to treat recently and we present a brief review of the literature.     

The influence of aspirin on the course of induced midtrimester abortion

Prostaglandins appear to mediate the uterine contractions of abortion and labor, and aspirin has been shown to be an inhibitor of prostaglandin synthesis. In this double-blind, placebo-controlled, prospective, and randomized study, aspirin was administered orally in doses of 600 mg. every 6 hours to patients undergoing induced midtrimester abortions with hyperosmolar urea and oxytocin augmentation. The mean injection-abortion interval was significantly prolonged by aspirin in nulliparous patients (aspirin 32.3 ± 3.3 hr. vs. placebo 21.5 ± 3.5 hr.) and no aspirin-treated nullipara aborted in less than 18 hours. There was no significant difference between treatment groups in the mean injection-abortion interval in the multiparous patients at the dose of aspirin used. The effectiveness of aspirin in the prolongation of the injection-abortion interval has potential therapeutic implications for the treatment of premature labor.     

Co-existence of malignant squamous cells and herpes simplex virus type 2-infected cells

A case is presented in which malignant squamous cells and herpes virus infected cells were recognized concomitantly at routine cytologic examination for detection of cervical cancer. Further examinations on admission revealed Stage 1b carcinoma of the cervix and characteristic pathologic changes of herpetic infection in the tumor cell nests. Virus was isolated from the cancerous tissues in the ectocervix following radical hysterectomy, and was identified as herpes simplex virus type 2 (HSV-2). The typical HSV-2 particles were detected by electron microscopic observation on the infected FL monolayer cells with isolation. Neutralizing antibody levels against HSV-2 declined and remained low after hysterectomy. The HSV-2, isolated and identified, might be considered as “passenger” virus. The role of this isolated virus as an etiologic agent of the cervical cancer was not clear.     

Multiple primaries among gynecologic malignancies

Seventy-eight synchronous or metachronous tumors among 2362 patients followed by the Downstate Gynecologic Tumor Registry are reviewed. Significant synchronous tumor pairs include cervix (invasive and in situ)-ovary, cervix (in situ)-uterus, cervix (in situ)-kidney, endometrium-ovary, endometrium-rectosigmoid and ovary-breast. Significant metachronous pairs include cervix (invasive and in situ combined)-lung, cervix (invasive and in situ combined)-upper alimentary tract, and cervix (invasive)-rectosigmoid. In the case of in situ and invasive cervical cancer-lower genital tract, significance was determined for both synchronous and metachronous pairs. Long survival is an important factor in the appearance of a second tumor as demonstrated in patients with cervical carcinoma. Synchronous data prove to be valuable in assessing risk of second primaries in patients surviving for short periods. The roles of cigarette smoking, hormones, immunosuppression, radiotherapy, and screening are discussed.     

浅谈开展创新教育的研究与实践

妇产科教研室近几年来,临床课理论教学、见习、生产实习时;开展了培养学生创新思维和创新能力的研究与实践。;要求师生明确时代发展的基本特征及其要求,转变传统的教学观念,适应新的教学模式,跳出学科本位思想的束缚,拓宽学生的知识面,汲取更多、更新的知识。实施三个转变即以教师为中心向学生为中心的转变,由统一课程向选修课程的转变,由学科基础向问题基础的转变。见习课、生产实习坚持“以人为本”的模式,师生互动、强调个性、重在品德、突出创新思维和新观念;探索创新教育规律;对大学生进行创新意识的培养;通过授课、见习、读书报告会、有关知识抢答赛、义诊等活动相结合实施;培养模式的多样化与培养方案的个性化;学生创新意识提高,自主学习能力增强。几年来,多次学生的座谈会、意见反馈,学生对妇产科教学反映较好。认为师资队伍齐,创新意识强;给了学生～个创新思维和创新能力锻炼的空间。每次效果评分均在90分以上。院教学办每学期的教学质量评估均在前茅：     

妇科腹腔镜手术并发症相关因素的分析

目的:探讨腹腔镜手术的并发症及其相关因素。方法:回顾性分析我院7 年中2946例腹腔镜手术病例及25例出现并发症的患者相关因素。结果:腹腔镜手术并发症的发生率为0.85%(25/2946)。因并发症而需要中转开腹手术者6例(0.2%),子宫切除术、肌瘤剔除术、附件手术及其他手术的并发症发生率分别为5.3%(7/133)、2.0%(5/246)、0.50%(11/2189)及0.53%(2/378)。穿刺及气腹有关的并发症11例(0.37%);术中并发症6例(0.28%);术后并发症8例(0.2%)。子宫切除术并发症的发生率远高于子宫肌瘤剔除手术及附件手术(P<0.01)。结论:妇科腹腔镜手术的并发症不容忽视,其并发症的发生与手术的难度有关。     

参与式教学方法在妇产科学教学中的应用

本文探讨了参与式教学方法在妇产科学教学中的应用，发现参与式教学方法提高了学生的学习兴趣和积极性，有利于促进学生个性发展和知识面拓展，培养了学生的创新能力，活跃了课堂气氛，增加了学生与教师的交流机会，融洽了师生关系。但是，参与式教学方法消耗时间过多，不宜推广到每一堂课。