BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease(VKH).Nonetheless,administering substantial doses of steroids to pregnant women necessitates metic...BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease(VKH).Nonetheless,administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus.We present a case wherein steroid pulse therapy was administered to a patient who developed VKH during the late stages of pregnancy.CASE SUMMARY The patient was a 26-year-old nulliparous woman.At 33 weeks and 1 day of her pregnancy,she experienced a decline in visual acuity and noticed metamorphopsia in her left eye.Examination revealed bilateral serous retinal detachment,leading to VKH diagnosis.A collaborative effort involving the departments of ophthalmology,internal medicine,and neonatology was initiated.Steroid pulse therapy was administered at 34 weeks and 1 day of pregnancy under hospital supervision.Complications,such as threatened preterm labor and gestational diabetes,emerged,necessitating the initiation of oral ritodrine hydrochloride and insulin therapy.Then,serous retinal detachment was resolved,and visual acuity was restored.Labor pains initiated 32 days post-initiation of steroid pulse therapy(at 38 weeks and 4 days of gestation),culminating in a normal delivery.Mother and newborn experienced an uneventful puerperal course and were discharged from the hospital on the 5th day following delivery.CONCLUSION VKH management in pregnancy requires multidisciplinary coordination,emphasizing collaboration with ophthalmologists and specialists in internal medicine and neonatology.展开更多
BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children w...BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children with Robert’s uterus who was examined and treated by laparoscopy and hysteroscopy.Unlike the existing cases reported in the literature,this patient had a late onset of Robert’s uterus symptoms.Due to right tubal ectopic pregnancy 3 years previously,the patient was treated with right salpingectomy and left tubal ligation but suffered aggravated left lower abdominal pain.She was examined and treated by laparoscopy and hysteroscopy,and is completely asymptomatic at 5-year followup.CONCLUSION The typical obstructive Mullerian abnormality requires further surgery.Combined laparoscopy and hysteroscopy is an effective,minimally invasive technique with better recovery outcomes than traditional transabdominal procedures.展开更多
文摘目的 探究双侧髂内动脉Fogarty球囊阻断术在剖宫产术后瘢痕妊娠(CSP)辅助清宫手术中的临床疗效与安全性。方法 回顾性分析阜阳市人民医院2021年1月至2022年9月收治的80例CSP患者临床资料。其中观察组40例,给予双侧髂内动脉Fogarty球囊阻断术下行宫腔镜下清宫治疗,术中间断阻断髂内动脉,清除胚胎、电凝或缝合止血;对照组40例,给予子宫动脉栓塞术(UAE)后1~2 d行宫腔镜下清宫手术。对比分析两组患者在数字减影血管造影(DSA)下透视时间、体表辐射剂量、清宫手术中出血量、清宫手术时间、住院时间及术后随访情况。结果 所有患者清宫手术顺利,成功保留子宫。观察组未发生球囊相关的并发症。对照组40例患者UAE后均发生不同程度发热、子宫区疼痛等栓塞后反应。观察组、对照组DSA下透视时间及体表辐射剂量分别为(9.2±1.1)s vs(1 273.6±141.1)s、(7.7±0.8)m Gy vs(1 503.8±101.8)mGy,分别比较,差异均有统计学意义(均P<0.05);清宫时术中出血量分别为(30.3±14.7) mL、(27.5±13.2) mL,清宫手术时间分别为(41.6±16.2) min、(42.8±15.0) min,分别比较,差异均无统计学意义(均P>0.05);住院时间分别为(6.0±0.7) d、(7.3±0.8) d,两组比较,差异有统计学意义(P<0.05)。随访期均在3个月以上,观察组、对照组人绒毛膜促性腺激素(β-hCG)转阴时间、阴道流血时间、月经恢复正常时间及患者满意率分别为(21.1±2.4) d vs (24.6±3.3) d、(8.2±1.1) d vs (13.6±2.6) d、(29.5±2.2) d vs(46.7±7.3) d、95.0%(38/40) vs 67.5%(27/40),分别比较,差异均有统计学意义(均P<0.05)。结论 双侧髂内动脉Fogarty球囊阻断术及UAE辅助CSP清宫手术均可明显减少术中出血量,但双侧髂内动脉Fogarty球囊阻断术相比于UAE,减少患者X线辐射剂量,缩短患者住院、β-hCG转阴、阴道流血、月经恢复正常时间,增加患者满意度率。
文摘BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease(VKH).Nonetheless,administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus.We present a case wherein steroid pulse therapy was administered to a patient who developed VKH during the late stages of pregnancy.CASE SUMMARY The patient was a 26-year-old nulliparous woman.At 33 weeks and 1 day of her pregnancy,she experienced a decline in visual acuity and noticed metamorphopsia in her left eye.Examination revealed bilateral serous retinal detachment,leading to VKH diagnosis.A collaborative effort involving the departments of ophthalmology,internal medicine,and neonatology was initiated.Steroid pulse therapy was administered at 34 weeks and 1 day of pregnancy under hospital supervision.Complications,such as threatened preterm labor and gestational diabetes,emerged,necessitating the initiation of oral ritodrine hydrochloride and insulin therapy.Then,serous retinal detachment was resolved,and visual acuity was restored.Labor pains initiated 32 days post-initiation of steroid pulse therapy(at 38 weeks and 4 days of gestation),culminating in a normal delivery.Mother and newborn experienced an uneventful puerperal course and were discharged from the hospital on the 5th day following delivery.CONCLUSION VKH management in pregnancy requires multidisciplinary coordination,emphasizing collaboration with ophthalmologists and specialists in internal medicine and neonatology.
文摘BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children with Robert’s uterus who was examined and treated by laparoscopy and hysteroscopy.Unlike the existing cases reported in the literature,this patient had a late onset of Robert’s uterus symptoms.Due to right tubal ectopic pregnancy 3 years previously,the patient was treated with right salpingectomy and left tubal ligation but suffered aggravated left lower abdominal pain.She was examined and treated by laparoscopy and hysteroscopy,and is completely asymptomatic at 5-year followup.CONCLUSION The typical obstructive Mullerian abnormality requires further surgery.Combined laparoscopy and hysteroscopy is an effective,minimally invasive technique with better recovery outcomes than traditional transabdominal procedures.
