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1.
Michelle E. Miller Victoria M. Allen Jo-Ann K. Brock 《Journal d'obstetrique et gynecologie du Canada》2018,40(7):896-902
Objective
Fetal echogenic bowel (echogenic bowel) is associated with cystic fibrosis (CF), with a reported incidence ranging from 1% to 13%. Prenatal testing for CF in the setting of echogenic bowel can be done by screening parental or fetal samples for pathogenic CFTR variants. If only one pathogenic variant is identified, sequencing of the CFTR gene can be undertaken, to identify a second pathogenic variant not covered in the standard screening panel. Full gene sequencing, however, also introduces the potential to identify variants of uncertain significance (VUSs) that can create counselling challenges and cause parental anxiety. To provide accurate counselling for families in the study population, the incidence of CF associated with echogenic bowel and the carrier frequency of CFTR variants were investigated.Methods
All pregnancies for which CF testing was undertaken for the indication of echogenic bowel (from Nova Scotia and Prince Edward Island) were identified (January 2007–July 2017). The CFTR screening and sequencing results were reviewed, and fetal outcomes related to CF were assessed.Results
A total of 463 pregnancies with echogenic bowel were tested. Four were confirmed to be affected with CF, giving an incidence of 0.9% in this cohort. The carrier frequency of CF among all parents in the cohort was 5.0% (1 in 20); however, when excluding parents of affected fetuses, the carrier frequency for the population was estimated at 4.1% (1 in 25). CFTR gene sequencing identified an additional VUS in two samples.Conclusion
The incidence of CF in pregnancies with echogenic bowel in Nova Scotia and Prince Edward Island is 0.9%, with an estimated population carrier frequency of 4.1%. These results provide the basis for improved counselling to assess the risk of CF in the pregnancy, after parental carrier screening, using Bayesian probability. Counselling regarding VUSs should be undertaken before gene sequencing. 相似文献2.
3.
Background
In twin pregnancies, elective cerclage placement based on obstetrical history or ultrasound findings has been shown to be ineffective and even harmful. There are currently no guidelines for the use of rescue cervical cerclage in twin pregnancies.Case
The current report presents the case of a 33-year-old patient with monochorionic diamniotic twins (MCDA) found to have dilated cervix at 3.5cm with exposed membranes upon physical examination at 19 weeks and 3 days. An emergency McDonald cerclage was placed at 20 weeks and the patient carried the current pregnancy until 35weeks 6 days.Conclusion
Rescue cerclage represents an important option to consider in order to preserve twin pregnancies regardless of chorionicity. 相似文献4.
Alexandra Badescu Horace Roman Iulia Barsan Valentin Soldea Serban Nastasia Moutaz Aziz Lucian Puscasiu Simona Stolnicu 《Journal of minimally invasive gynecology》2018,25(3):522-527.e9
Study Objective
To document the presence of bowel invisible microscopic endometriosis implants and their relationship with deep endometriosis macronodule infiltrating the bowel.Design
A series of consecutive patients with deep endometriosis infiltrating the rectum and/or sigmoid colon (Canadian Task Force classification II-2).Settings
A university referral center.Patients
Ten patients managed by colorectal resection.Interventions
A microscopic study of endometriotic foci of the bowel involving 3272 microsection slides was established using a unique method of step serial sections using combined transverse and longitudinal macrosection. Two-dimensional reconstruction based on slide scanning highlighted the presence and localization of the deep endometriosis macronodule in contrast with bowel invisible microscopic endometriosis microimplants.Measurements and Main Results
The distance separating the microimplants and the nodule and their histologic characteristics. The mean length of the colorectal specimens was 91?±?19?mm. The maximum distance between the farthest microimplants was 7.2?cm. The maximum distance from the macroscopic nodule limit to the farthest microimplant was 31?mm. Bowel invisible microscopic endometriosis microimplants presented with similar features independently of the type of spread. They had an active appearance including stroma and glands, were sometimes decidualized, and were free of fibrosis. They were found on the distal/rectal limit of the specimen in 3 patients and on both limits (distal/rectal and proximal/sigmoid colon) in 1 patient.Conclusion
Invisible microscopic endometriosis implants surround the bowel macroscopic endometriosis nodule at variable distances, suggesting that complete surgical microscopic removal may be a challenging goal. These results may help to reconsider the principles and feasibility of the surgical management of bowel endometriosis. 相似文献5.
Alessandra Di Giovanni Lucia Casarella Marina Coppola Domenico Iuzzolino Marianna Rasile Mario Malzoni 《Journal of minimally invasive gynecology》2018,25(7):1231-1240
Study Objective
To assess the sensitivity and accuracy of combined transvaginal/ transabdominal ultrasonography (TV/TA US) for evaluation of deep infiltrating bowel endometriosis nodules measured after surgery.Design
Prospective study (Canadian Task Force classification II.1).Setting
A center for advanced endoscopic gynecologic surgery.Patients
All women undergoing laparoscopic surgery and scheduled for segmental resection for clinically suspected bowel endometriosis between January 2014 and December 2016.Interventions
In all women with clinically suspected bowel endometriosis, a US scan was performed before surgery to detect and measure the 3 diameters of bowel endometriotic lesions: longitudinal, anteroposterior, and transverse. These diameters were compared with those obtained by direct measurement on a fresh specimen. The sensitivity and specificity values of US evaluation were calculated, with 95% confidence intervals.Measurements and Main Results
The sensitivity and specificity of TV/TA US in the 328 patients of this study were 100% when rectal endometriotic lesions were investigated. The specificity was 100%, whereas the sensitivity decreased to 91.4% when sigmoid lesions were investigated. Bowel muscularis infiltration was histologically confirmed in all cases in which endometriotic lesions were detected by US (284 of 284; 100%). All missed sigmoid lesions (12 of 296) were located >25?cm from the anal verge. The mean diameters of endometriotic nodules calculated by US evaluation and by direct measurement on the fresh specimen were 43.19?×?19.87?×?10.79?mm and 42.76?×?19.64?×?10.62?mm, respectively, with no statistically significant differences between the 2 methods.Conclusion
We believe that US can be considered an accurate diagnostic technique for the evaluation of deep infiltrating bowel endometriosis when performed by a dedicated experienced sonographer in a specialized center. 相似文献6.
7.
Neha Jeirath Cindy M. Basinski Max A. Hammond 《Journal of minimally invasive gynecology》2018,25(5):836-841
Study Objective
To assess if follow-up confirmation testing 3 months after hysteroscopic sterilization with the Essure device (Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ) improved with recommendation for transvaginal ultrasound (TVUS) versus hysterosalpingogram (HSG).Design
Retrospective, observational case-controlled cohort study (Canadian Task Force classification II-2).Setting
Two-physician private practice in Evansville, Indiana.Patients
Compliance rates for a TVUS confirmation test on 100 women who underwent hysteroscopic sterilization compared with a previously published cohort of 1004 women who were scheduled to undergo an HSG confirmation test.Intervention
Acquisition of 3-month confirmation testing after Essure hysteroscopic sterilization.Measurement and Main Results
All women who underwent Essure hysteroscopic sterilization with recommendation for TVUS confirmation testing between July 2015 and January 2017 were compared with a previously published cohort of 1004 patients with recommendation for HSG confirmation testing (HSG cohort). In addition, an HSG subgroup cohort (HSG subgroup) similar in size and closest chronology to the TVUS cohort was drawn from the original 1004 patients and analyzed for HSG follow-up. Records for all patients were reviewed for demographic, procedural, and confirmation testing and outcome data. One hundred patients were identified with successful Essure device placement and a recommendation for TVUS confirmation testing. Eighty-eight patients (88.0%) returned for TVUS at 3 months. In the HSG cohort 1004 successful Essure devices were placed, and 778 patients returned for the recommended HSG follow-up (77.5%). There was a significantly higher follow-up rate for TVUS compared with the HSG cohort (88.0% vs 77.5%, p?=?.008). In the HSG subgroup 184 patients were identified, and 133 patients presented for HSG follow-up (72.3%), indicating a significantly higher follow-up rate in the TVUS cohort (88.0% vs 72.3%, p?=?.001). No pregnancies after any confirmation testing were noted.Conclusion
Confirmation testing with TVUS rather than HSG 3 months after Essure device placement results in increased patient compliance that may lead to improved patient outcomes with reduction of unintended pregnancy. 相似文献8.
Jennifer Tang Mara L. Sobel Ally Murji 《Journal d'obstetrique et gynecologie du Canada》2018,40(9):1186-1189
Background
Medical management using potassium chloride feticide and methotrexate is often the first-line approach to cervical pregnancies.Case
A 25-year-old woman presenting with a cervical ectopic pregnancy was unsuccessfully managed with conservative therapy, resulting in an arteriovenous malformation requiring a laparoscopic hysterectomy.Conclusion
Conservative management of ectopic pregnancies is the treatment of choice for young women looking to preserve fertility. However, medical management is not without risk, and this case illustrates one such complication. 相似文献9.
10.
Jianmin Chen Dong Huang Libing Shi Liuhang Zhang Dongjing Sun Xiaona Lin Songying Zhang 《Journal of minimally invasive gynecology》2018,25(6):1080-1087
Study Objective
To investigate the effect of cornual suture at the time of laparoscopic salpingectomy on the incidence of interstitial pregnancy (IP) after in vitro fertilization (IVF).Design
Single-center, retrospective review (Canadian Task Force classification II-2).Setting
University hospital.Patients
Patients with hydrosalpinx who were treated with salpingectomy before IVF-embryo transfer and managed in our center were included in this study.Interventions
A total of 542 patients who underwent laparoscopic salpingectomy from April 2011 to March 2014 comprised group A. A total of 502 patients who underwent cornual suture at the time of laparoscopic salpingectomy from April 2014 to February 2016 comprised group B.Measurements and Main Results
The overall IP rate was significantly lower in group B (7/293, 2.39%) than in group A (27/373, 7.24%; p?<?.05). The intrauterine pregnancy and ongoing pregnancy/live birth rates were significantly higher in group B than in group A (both p?<?.05). All 34 patients with IP underwent laparoscopic cornuostomy and cornual repair. Seven of 11 patients with combined interstitial and intrauterine pregnancies carried the intrauterine pregnancy to term and delivered via cesarean section, whereas 4 patients underwent inevitable miscarriage. IP rupture occurred in 8 of 34 patients at a mean of 23.43?±?2.77 days after embryo transfer. The earliest time of rupture was on day 20 after embryo transfer.Conclusion
An optimized salpingectomy technique plays an important role in pretreatment before embryo transfer in patients with hydrosalpinx. Cornual suture at the time of salpingectomy helps reduce the risk of IP. 相似文献11.
Maria Grazia Porpora Valeria Vinci Corrado De Vito Giuseppe Migliara Emanuela Anastasi Adele Ticino Serena Resta Carlo Catalano Pierluigi Benedetti Panici Lucia Manganaro 《Journal of minimally invasive gynecology》2018,25(4):661-669
Objectives
To evaluate the sacral nerve root features by the means of magnetic resonance imaging–diffusion tensor imaging (MRI-DTI) tractography in women with endometriosis and/or adenomyosis, and to analyze the correlations among DTI abnormalities, pain symptoms, and endometriotic lesions found at surgery.Design
A cross-sectional, observational study (Canadian Task Force classification II-2).Setting
University hospital.Patients
Women (n?=?76) with clinical suspicion of endometriosis.Interventions
Before surgery, dysmenorrhea, deep dyspareunia, and noncyclic pelvic pain (NCPP) were assessed using a 10-point visual analog scale. MRI enabled a 3-dimensional reconstruction of S1, S2, and S3. Fractional anisotropy was calculated for each root. Laparoscopic treatment of endometriosis was performed in 56 patients.Measurements and Main Results
Our findings revealed correlations among sacral root reconstruction by MRI-DTI, pain symptoms, and laparoscopic findings. DTI of sacral roots revealed a regular and homogeneous appearance in 17 patients (25.8%) and abnormalities in microstructure reconstruction, with fiber irregularities and disorganization and loss of the simple unidirectional course, in 44 patients (66.7%). At laparoscopy, ovarian endometriomas were found in 82.1% of the patients, and deeply infiltrating endometriosis (DIE) were found in 57.1%. Endometriosis was staged according to the revised American Society for Reproductive Medicine classification. Pathological DTI findings were significantly associated with the severity of dysmenorrhea and NCPP, pain duration, presence of tubo-ovarian and cul-de-sac adhesions, and DIE.Conclusion
The presence of pathological DTI findings of the sacral nerve roots correlates with the type of pain, adhesions, and DIE. At present, DTI can be useful for providing a better understanding of pain; however, DTI could become a useful tool in therapeutic planning for patients with endometriosis. 相似文献12.
Caterina Exacoustos Giovanna De Felice Alessandra Pizzo Giulia Morosetti Lucia Lazzeri Gabriele Centini Emilio Piccione Errico Zupi 《Journal of minimally invasive gynecology》2018,25(5):884-891
Study Objective
To assess the association between ovarian endometriomas detectable at transvaginal ultrasound (TVS) and other specific extraovarian lesions including adhesions, deep infiltrating endometriosis (DIE), and adenomyosis.Design
Retrospective observational study (Canadian Task Force classification II-2).Setting
Two university hospitals.Patients
Two hundred fifty-five symptomatic women with at least 1 ovarian endometrioma found on ultrasound after presentation with pain or irregular menstruation.Interventions
Patients underwent TVS followed by either medical or surgical treatment.Measurements and Main Results
Two hundred fifty-five women, aged 20 to 40 years, underwent TVS and were found to have at least 1 endometrioma with a diameter?>?20?mm. Associated sonographic signs of pelvic endometriosis (adhesions, DIE, and adenomyosis) were recorded, and a subgroup of patients (n?=?50) underwent laparoscopic surgery within 3 months of TVS. Mean endometrioma diameter was 40.0?±?18.1?mm, and bilateral endometriomas were observed in 65 patients (25.5%). TVS showed posterior rectal DIE in 55 patients (21.5%) and a thickening of at least 1 uterosacral ligament in 93 patients (36.4%). One hundred eighty-six patients (73%) had adhesions, and 134 patients (53%) showed signs of myometrial adenomyosis on TVS. Thirty-eight patients (15%) exhibited only a single isolated endometrioma with a mobile ovary and no other signs of pelvic endometriosis/adenomyosis at TVS.Conclusion
Ovarian endometriomas are indicators for pelvic endometriosis and are rarely isolated. Particularly, left endometriomas were found to be associated with rectal DIE and left uterosacral ligament localization and bilateral endometriomas correlated with adhesions and pouch of Douglas obliteration, whereas no correlation was found between endometrioma size and DIE. Determining appropriate management, whether clinical or surgical, is critical for ovarian endometriomas and concomitant adhesions, endometriosis, and adenomyosis in patients desiring future fertility. 相似文献13.
David Sheyn Sherif El-Nashar Megan Billow Sangeeta Mahajan Mary Duarte Robert Pollard 《Journal of minimally invasive gynecology》2018,25(3):484-490
Study Objective
To determine if there is a difference in readmission rates after same-day discharge compared with postoperative day 1 discharges after laparoscopic hysterectomy.Design
A retrospective cohort study with 1:2 propensity score matching (Canadian Task Force classification II-2).Setting
American College of Surgeons National Surgical Quality Improvement Program database.Patients
Women undergoing benign laparoscopic total or supracervical hysterectomy or laparoscopic-assisted vaginal hysterectomy with or without adnexal surgery between the years 2010 to 2015.Interventions
Three thousand thirty-two low-risk women discharged on postoperative day 0 and 6064 women discharged on postoperative day 1 were included in the analysis.Measurements and Main Results
The overall readmission rate was 1.8%; after same-day discharge, the readmission rate was 2.2%, and after postoperative day 1 discharge the readmission rate was 1.7% (p?=?.10). After logistic regression analysis, smoking (adjusted odds ratio [aOR]?=?2.06; 95% confidence interval [CI], 1.49–2.88), nonwhite race (aOR?=?1.53; 95% CI, 1.1007–2.14), and cystoscopy (aOR?=?2.05; 95% CI, 1.49–2.82) were associated with an increased risk of readmission.Conclusion
There was no statistically significant difference in readmission rates after laparoscopic hysterectomy between women discharged on the day of surgery or postoperative day 1. 相似文献14.
Jenny-Claude Millochau Emanuela Stochino-Loi Basma Darwish Carole Abo Julien Coget Rachid Chati Jean-Jacques Tuech Horace Roman 《Journal of minimally invasive gynecology》2018,25(1):139-146
Study Objective
To report postoperative outcomes after dual digestive resection for deep endometriosis infiltrating the rectum and the colon.Design
A retrospective study using data prospectively recorded in the CIRENDO database (Canadian Task Force classification II-2).Setting
A university tertiary referral center.Patients
Twenty-one patients managed for multiple colorectal deep endometriosis infiltrating nodules.Interventions
Concomitant disc excision and segmental resection of both the rectum and sigmoid colon.Measurements and Main Results
The assessment of postoperative outcomes was performed. Rectal nodules were managed by disc excision and segmental resection in 20 patients and 1 patient, respectively. Sigmoid colon nodules were removed by short segmental resection and disc excision in 15 and 6 patients, respectively. The rectal nodule diameter was between 1 and 3?cm and over 3?cm in 33% and 67% of patients, respectively. Associated vaginal infiltration requiring vaginal excision was recorded in 76.2% of patients. The mean diameter of the rectal disc removed averaged 4.6?cm, and the mean height of the rectal suture was 5.8?cm. The length of the sigmoid colon specimen and the height of the anastomosis were 7.3?cm and 18.5?cm, respectively. The mean operative time was 290 minutes, and the mean postoperative follow-up averaged 30 months. Clavien-Dindo 3 complications occurred in 28% of patients, including 4 with rectal fistulae (19%). The pregnancy rate was 67% among patients with pregnancy intention.Conclusion
Our data suggest that combining disc excision and segmental resection to remove multiple deep endometriosis nodules infiltrating the rectum and the sigmoid colon can preserve the healthy bowel located between 2 consecutive nodules. However, the rate of postoperative complications is high, particularly in patients with large low rectal nodules. 相似文献15.
Krystel Nyangoh Timoh Zelda Stewart Mikhael Benjoar Selma Beldjord Marcos Ballester Marc Bazot Isabelle Thomassin-Naggara Emile Darai 《Journal of minimally invasive gynecology》2018,25(4):697-705
Study Objective
To prospectively determine the accuracy of magnetic resonance enterography (MRE) compared with conventional magnetic resonance imaging (MRI) for multifocal (i.e., multiple lesions affecting the same digestive segment) and multicentric (i.e., multiple lesions affecting several digestive segments) bowel endometriosis.Design
A prospective study (Canadian Task Force classification II-2).Setting
Tenon University Hospital, Paris, France.Patients
Patients with MRI-suspected colorectal endometriosis scheduled for colorectal resection from April 2014 to February 2016 were included.Interventions
Patients underwent both 1.5-Tesla MRI and MRE as well as laparoscopically assisted and open colorectal resections.Measurements and Main Results
The diagnostic performance of MRI and MRE was evaluated for sensitivity, specificity, positive and negative predictive values, accuracy, and positive and negative likelihood ratios (LRs). The interobserver variability of the experienced and junior radiologists was quantified using weighted statistics. Forty-seven patients were included. Twenty-two (46.8%) patients had unifocal lesions, 14 (30%) had multifocal lesions, and 11 (23.4%) had multicentric lesions. The sensitivity, specificity, positive LR, and negative LR for the diagnosis of multifocal lesions were 0.29 (6/21), 1.00 (23/24), 15.36, and 0.71 for MRI and 0.57 (12/21), 0.89 (23/25), 4.95, and 0.58 for MRE. The sensitivity, specificity, positive LR, and negative LR for the diagnosis of multicentric lesions were 0.18 (1/11), 1.00 (1/1), 15, and 0.80 for MRI and 0.46 (5/11), 0.92 (33/36), 5.45, and 0.60 for MRE. Lower accuracies for MRI compared with MRE to diagnose multicentric (p?=?.01) and multifocal lesions (p?=?.004) were noted. The interobserver agreement for MRE was good for both multifocality (κ?=?0.80) and multicentricity (κ?=?0.61).Conclusion
MRE has better accuracy for diagnosing multifocal and multicentric bowel endometriosis than conventional MRI. 相似文献16.
Ryan E. Lamont Yanwei Xi Claire Popko Joanna Lazier Francois P. Bernier Julie L. Lauzon A. Micheil Innes Jillian S. Parboosingh Mary Ann Thomas 《Journal d'obstetrique et gynecologie du Canada》2018,40(11):1417-1423
Objective
Most prenatally identified congenital heart defects (CHDs) are the sole structural anomaly detected; however, there is a subgroup of cases where the specific genetic cause will impact prognosis, including chromosome abnormalities and single-gene causes. Next-generation sequencing of all the protein coding regions in the genome or targeted to genes involved in cardiac development is currently possible in the prenatal period, but there are minimal data on the clinical utility of such an approach. This study assessed the outcome of a CHD gene panel that included single-gene causes of syndromic and non-syndromic CHDs.Method
Sixteen cases with a fetal CHD identified on prenatal ultrasound were studied using a 108 CHD gene panel. DNA was extracted from cultured amniocytes.Results
There was no diagnostic pathogenic variant identified in these cases. There was an average of 2.9 reportable variants identified per case and the majority of them were variants of uncertain significance.Conclusion
Next-generation sequencing has the potential for increased genetic diagnosis for fetal anomalies. However, the large number of variants and the absence of an examinable patient make the interpretation of these variants challenging. 相似文献17.
Floriana Mascilini Lorena Quagliozzi Francesca Moro Maria Cristina Moruzzi Valerio Gallotta Salvatore Gueli Alletti Giovanni Scambia Antonia Carla Testa Anna Fagotti 《Journal of minimally invasive gynecology》2018,25(5):848-854
Study Objective
To describe the potential role of intraoperative ultrasound (IOUS) in the detection and localization of recurrent disease in gynecologic cancer patients during minimally invasive surgery (MIS).Design
A prospective cohort study (Canadian Task Force classification II-1).Setting
A university hospital.Patients
Fifty-one gynecologic cancer patients with isolated recurrent disease.Interventions
IOUS during secondary cytoreductive surgery (SCS) by MIS.Measurements and Main Results
From November 2015 to February 2017 51 gynecologic cancer patients with isolated recurrent disease and candidates for SCS were treated by MIS. Recurrent tumor was preoperatively assessed at clinical examination, transvaginal and transabdominal sonography, and radiologic evaluation in all women. Twelve of 51 women (23.5%) needed IOUS. Type of disease was ovarian in 5 women (42%), endometrial in 4 (33%), cervical in 1 (8%), vaginal cancer in 1 (8%), and uterine sarcoma in 1 (8%). Recurrence was localized deep in the pelvis in 7 cases (58%), lymph nodes in 3 (25%), and extraperitoneal in 2 cases (17%). Recurrence was dimmed in the surgical field, due to either presence of adherences, deep anatomic position, small size, and/or lack of tactile feeling. IOUS was able to identify the lesions in all women, allowing MIS (83% laparoscopy and 17% robotic) complete cytoreduction, with no conversion to laparotomy. Median operative time was 150 minutes (range, 77–280). No intraoperative/postoperative complications occurred. Histologic examination confirmed the presence of recurrence in 11 of 12 cases (92%), whereas the remaining case showed inflammatory tissue. With a median follow-up time of 15 months (range, 6–19), all patients except 2 were still alive.Conclusions
About 1 of 4 patients (25%) with single gynecologic cancer recurrence needs IOUS to benefit from MIS for complete secondary cytoreduction. 相似文献18.
Francesco Cosentino Giuseppe Vizzielli Luigi Carlo Turco Anna Fagotti Stefano Cianci Virginia Vargiu Gian Franco Zannoni Gabriella Ferrandina Giovanni Scambia 《Journal of minimally invasive gynecology》2018,25(7):1249-1254
Study Objective
To evaluate near-infrared radiation imaging with intravenous indocyanine green (NIR-ICG) during laparoscopic intervention to identify endometriosis lesions.Design
A single-center, prospective, single-arm pilot study (Canadian Task Force classification II-2).Setting
An academic tertiary care and research center.Patients
Twenty-seven patients with symptomatic endometriosis were enrolled.Interventions
Patients underwent laparoscopic surgery using a laparoscopic system prototype with NIR-ICG.Measurements and Main Results
A total of 116 suspected endometriosis lesions were removed from 27 patients. One hundred lesions had already been visualized in white light imaging by an expert surgeon; the remaining 16 were detected and removed using NIR-ICG. A total of 111 specimens were positive for endometriosis pathology. Positive predictive value of 95% and 97.8% and negative predictive value of 86.2% and 82.3% were found by white light imaging and NIR-ICG, respectively, with sensitivity of 85.6% and 82% and specificity of 95.2% and 97.9%, respectively.Conclusion
NIR-ICG may be a tool for intraoperative diagnosis, confirmation of visible endometriosis lesions, and a marker for identifying occult endometriosis. Further prospective studies with a larger population sample are warranted to validate these encouraging preliminary results. 相似文献19.
Chung-Yuan Yang Chuan-Chi Kao Shuenn-Dyn Chang Shih-Yin Huang 《Taiwanese journal of obstetrics & gynecology》2018,57(1):106-109
Objective
To present a case with prenatal diagnosis and cytogenetic characterization of 1p36 deletion syndrome whose first trimester combined testing is abnormal but a normal NIPT result.Case report
A 33-year-old had an abnormal 1st trimester fetal aneuploidy screening result, but no trisomies 13, 18, 21 were detected by the noninvasive prenatal testing. Amniocentesis was performed after ultrasound showed fetal ventriculomegaly and echogenic bowel. The final conventional cytogenetics revealed a karyotype of 46, XX, del(1)(p36).Conclusion
Every prenatal genetic screening test and diagnostic procedure has its benefit and risk. NIPT offers better sensitivity and specificity for trisomies 13, 18, and 21. Even so, for primary population screening, NIPT provides lower detection rate than sequential screening if considering detection of all chromosomal abnormalities. Diagnostic testing should be offered rather than cell-free DNA screening to pregnant women if a fetal structural anomaly is identified on ultrasound examination. 相似文献20.
Huan Huang Chunxia Cheng Grace Johnson Ruoyi Wang Min Xue Aiqian Zhang Dabao Xu Xiaoming Guan 《Journal of minimally invasive gynecology》2018,25(4):583-584