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Editorial 总被引:1,自引:0,他引:1
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Martha Hickey MD MBBS MRCOG Ian S. Fraser MD FRANZCOG FRCOG CREI 《Best practice & research. Clinical obstetrics & gynaecology》2000,14(6):937-951
Menstrual disturbances are one of the most common problems presenting to the gynaecologist. In order for the endometrium to bleed, vessels must break down. Disruption in the regulation of endometrial vascular growth and function has been found in association with spontaneous and sex steroid-induced disturbances of menstrual bleeding. Although circulating oestrogens and progestogens influence the endometrial vessels, this effect appears to be indirect, and regulation is primarily via local factors. Deficient vasoconstriction and haemostasis with excessive fibrinolysis is seen in menorrhagia. Breakthrough bleeding in users of progestogen-only contraceptives is associated with increased superficial vascular fragility and disruptions in the supporting basement membrane. Blood vessels in uterine fibroids are abnormal in distribution and appearance. Adenomyosis is also commonly associated with menstrual disturbance, and alterations in vascular distribution suggest altered angiogenesis. Successful human embryo implantation requires endometrial vascular breakdown. Excessive thrombosis associated with the antiphospholipid syndrome may interfere with this re-modelling and compromise implantation. Arteriovenous malformations are a rare but important cause of excessive or irregular vaginal bleeding. Abundant vessels with abnormal morphology, associated with aberrant angiogenesis can be seen, and embolization of these vessels may be an effective conservative treatment. Improved understanding of the regulation of the uterine vasculature is likely to lead to targeted therapies to prevent unscheduled vascular breakdown and to control menstrual disturbance at an endometrial level. 相似文献
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Alan Lam MBBS FRACOG FRCOG Associate Professor Yuval Kaufman BSc MD Fellow at CARE Su Yen Khong MBChB MRCOG Fellow at CARE Andy Liew MBBS BSc FANZCA Stephen Ford MBBS BSc FANZCA VMO Anaesthetist George Condous MRCOG FRANZCOG Associate Professor 《Best practice & research. Clinical obstetrics & gynaecology》2009,23(5):631-646