Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 Edition

Total Page:16

File Type:pdf, Size:1020Kb

Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 Edition doi:10.1111/jog.13831 J. Obstet. Gynaecol. Res. 2019 Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 edition Ryuji Kawaguchi1 , Koji Matsumoto2, Shigeo Akira3, Ken Ishitani4, Kazuhiro Iwasaku5, Yutaka Ueda6, Ryugo Okagaki7, Hiroya Okano8, Toshimichi Oki9, Kaori Koga10, Michiko Kido11, Takumi Kurabayashi12, Yasushi Kuribayashi13,YuichiSato14, Kaori Shiina15, Yasushi Takai16, Satoshi Tanimura17, Osamu Chaki18, Masakazu Terauchi19, Yukiharu Todo20, Yasuyuki Noguchi21, Sayaka Nose-Ogura22, Tsukasa Baba23,AkiraHirasawa24, Takuma Fujii25,TsuneoFujii26, Tetsuo Maruyama27, Etsuko Miyagi28, Kaoru Yanagida29, Osamu Yoshino30, Mitsutoshi Iwashita31, Tsugio Maeda32, Takashi Minegishi33 and Hiroshi Kobayashi1 1Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, 2Department of Obstetrics and Gynecology, Showa University School of Medicine, 3Department of Obstetrics and Gynecology, Nippon Medical School, 4Department of Obstetrics and Gynecology, Kitasato University Kitasato Institute Hospital, 8Iidabashi Ladies Clinic, 10Department of Obstetrics and Gynecology, The University of Tokyo, 11Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, 13Center for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, 19Department of Women’s Health, Tokyo Medical and Dental University, 22Japan Institute of Sports Sciences, 27Department of Obstetrics and Gynecology, Keio University School of Medicine, 31Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, 5Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, School of Nursing, 23Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, 6Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, 7Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Saitama, 9Department of Reproductive Health Nursing, School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, 12Department of Obstetrics and Gynecology, Niigata City General Hospital, Niigata, 14Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, Takasaki, 15Udagawa Gynecological Clinic, Chiba, 16Department of Obstetrics and Gynecology, Saitama Medical Center/Saitama Medical University, Kawagoe, 17Department of Obstetrics and Gynecology, Toyama Central Prefectural Hospital, 30Department of Obstetrics and Gynecology, University of Toyama, Toyama, 18Department of Obstetrics and Gynecology, Yokohama Rosai Hospital, 28Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, 20Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, 21Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, 24Department of Clinical Genomic Medicine. Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 25Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Toyoake, 26Fujii Ladies’ Clinic, Hiroshima, 29Center for IVF and Infertility, International University of Health and Welfare Hospital, Nasushiobara, 32Maeda Clinic, Yaizu and 33Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan Abstract Six years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the third revised edition was published in 2017. The 2017 Guidelines includes 10 additional clinical questions (CQ), which brings the total to 95 CQ (12 on infectious disease, 28 on oncology and benign tumors, 27 on Received: August 7 2018. Accepted: September 15 2018. Correspondence: Dr Ryuji Kawaguchi, Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan. Email: [email protected] © 2019 Japan Society of Obstetrics and Gynecology 1 http://guide.medlive.cn/ R. Kawaguchi et al. endocrinology and infertility and 28 on healthcare for women). Currently a consensus has been reached on the Guidelines and therefore the objective of this report is to present the general policies regarding diagnos- tic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding recommendation level (A, B, C) is indicated. Key words: gynecologic oncology, gynecology, infections, reproductive endocrinology and infertility, urogynecology. Introduction least 80% of the Committee that prepared these guide- lines. Recommendation levels are not necessarily The Guidelines for Gynecological Practice 2017 is the based on evidence level. Their implications are as fol- third edition. It is the product of revisions that were lows: Level A indicates that implementation is included every 3 years since the publication of the strongly recommended, Level B indicates that imple- first edition in 2011. The 2017 Guidelines was jointly mentation is recommended and Level C indicates that edited and published by The Japan Society of Obstet- implementation or other action is to be considered. rics and Gynecology and The Japan Association of Some answers contain recommended tests and/or Obstetricians and Gynecologists. The Guidelines are treatments that may be difficult for some facilities to intended for use by physicians routinely involved in provide. In such cases, it is to be understood that the gynecological outpatient care. Our fundamental pol- guidelines imply that gynecologists are to ‘consult icy regarding its creation was to examine papers pub- with facilities that are able to provide the services and lished in Japan and overseas by July 2016 and identify refer and transfer patients to such facilities’. A specific and recommend testing procedures and treatment example of such a case would be ‘In cases in which methods determined to be practically applicable in at your own medical facility is incapable of providing a least 80% of the regions of the world and that had treatment, consultation with and referral to a facility benefits that greatly outweighed any potential risks that is capable of providing the treatment is A: known at the time they were published. strongly recommended, B: recommended, C: should The 2017 edition contains 95 clinical questions be considered’. (CQ). These include 10 new CQ that were added in response to needs that arose since the previous edi- tion (microwave endometrial ablation, familial cancer, Contents amenorrhea due to weight loss, care of female ath- letes, congenital uterine malformation, ovulation Chapter A. Infectious disease (CQ101–CQ112) induction methods, fertility preservation in patients Chapter B. Oncology and benign tumors (CQ201– with malignant tumors, violence and abuse by part- CQ228) ners, lifestyle-related diseases and female lower uri- Chapter C. Endocrinology and Infertility (CQ301– nary tract symptoms). In addition to Clinical CQ327) Questions and Answers, the original edition of The Chapter D. Healthcare for women (CQ401–CQ428) Guidelines for Gynecological Practice in Japan 2017 also contained key words, descriptions of implications A. Infectious disease and a reference section. These have all been omitted from this report due to space limitations. CQ101 How do we diagnose and treat chlamydial cervicitis? Answer Implications of ‘A’, ‘B’ and ‘C’ 1. Diagnose by testing for the presence of chlamydia recommendation levels in cervical swab specimens using nucleic acid amplification methods (e.g. PCR, SDA, TMA). (A) The recommendation levels are the result of compre- 2. Test for gonococcus simultaneously using nucleic hensive consideration of factors such as clinical effec- acid amplification methods. (B) tiveness, evidence, prevalence and medical economics 3. Treat with macrolide or quinolone oral antibi- and have been determined based on a consensus of at otics. (A) 2 © 2019 Japan Society of Obstetrics and Gynecology http://guide.medlive.cn/ Guidelines office gynecology in Japan 4. Determine the treatment outcome at 3 weeks after Answer the conclusion of drug administration. (B) 1. Clinical symptoms and presentation are usually 5. Recommend that the patient’s partner(s) be tested sufficient for diagnosis. Biopsy and pathological and treated. (B) evaluation can be performed when necessary. (B) 2. Treat with topical creams containing 5% imiqui- CQ102 mod. (B) How do we diagnose and treat gonococcus infection? 3. Surgical therapy involving direct excision, cryo- Answer therapy, electrocauterization and laser vaporiza- 1. Diagnose genital infection by testing for pathogens tion. (C) in cervical swab specimens using nuclei acid amplification methods or isolation culture. (A) CQ105 2. In cases in which pharyngeal gonococcal infection How do we screen for sexually transmitted infections is suspected, collect a pharyngeal specimen and (set testing)? test using the aforementioned methods. (C) Answer 3. Test for chlamydia simultaneously using nucleic 1. Test for the following four diseases: Genital chla- acid amplification methods. (B) mydia infection (cervical canal), gonococcal infec- 4. Treat with single administration of ceftriaxone tion (cervical canal), syphilis (blood) and HIV (intravenous injection) or spectinomycin (intramus- infection
Recommended publications
  • Successful Uterovaginal Anastomosis in an Unusual Presentation Of
    JSAFOMS Successful Uterovaginal Anastomosis in an Unusual Presentation10.5005/jp-journals-10032-1056 of Congenital Absence of Cervix CASE REPORT Successful Uterovaginal Anastomosis in an Unusual Presentation of Congenital Absence of Cervix 1Nusrat Mahmud, 2Naushaba Tarannum Mahtab, 3TA Chowdhury, 4Anjan Kumar Deb ABSTRACT Source of support: Nil Cervical agenesis or dysgenesis (fragmentation, fibrous cord Conflict of interest: None and obstruction) is an extremely rare congenital anomaly. Conser vative surgical approach to these patients involves uterovaginal anastomosis, cervical canalization and cervical INTRODUCTION reconstruction. In failed conservative surgery, total hysterec- Primary amenorrhea is defined as absence of menstrua- tomy is the treatment of choice. We report what we believe to be the first successful end-to-end uterovaginal anastomosis of tion by the age of 14 years in the absence of secondary an unusual case of congenital cervical agenesis. A 25-year- sex characteristics or the absence of periods by the age of old female presented complaining of primary amenorrhea 16 years regardless of appearance of secondary sex and primary subfertility for the same duration. At laparoscopy, complete separation between the cervix and the body of the charac ters. In our last study, a series of total 108 cases uterus was found and hanging from surrounding supports. of primary amenorrhea were reviewed. It was found Both ovaries and fallopian tubes were anatomically positioned. that 69.4% were due Müllerian dysgenesis, 19.4% due to There was another muscular tissue of 2 cm in diameter at the gonadal dysgenesis, 2.7% male pseudohermaphroditism pouch of Douglas which was attached with lateral pelvic wall 13 by transverse cervical ligament.
    [Show full text]
  • Septate Uterus As Congenital Uterine Anomaly: a Case Report
    em & yst Se S xu e a v l i t D c i s u o Reproductive System & Sexual Moghadam et al., Reprod Syst Sex Disord 2014, 3:4 d r o d r e p r e DOI: 10.4172/2161-038X.1000141 s R ISSN: 2161-038X Disorders: Current Research Case Report Open Access Septate Uterus as Congenital Uterine Anomaly: A Case Report Abas Heidari Moghadam1,2, Zahra Jozi1, Shapoor Dahaz1 and DarioushBijan Nejad1* 1Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapour University of Medical Sciences (AJUMS), Ahvaz, Iran 2Diagnostic Imaging Center of Ahvaz Oil Grand Hospital, Ahvaz, Iran *Correspondingauthor: Darioush Bijan Nejad, Assistant Professor, Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapour University of Medical Sciences (AJUMS), Ahvaz, Iran, Tel: +98 918 343 4253; Fax: +98 611 333 6380; E-mail:[email protected] Received: June 14, 2014; Accepted: August 01, 2014; Published: August 08, 2014 Copyright: © 2013 Moghadam AH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Abnormal fusion of Mullerian duct in embryonic life is the origin of variety of malformations which may alter the reproductive outcome of the patients. Septate uterus is caused by incomplete resorption of the Mullerian duct during embryogenesis. Here, we report a case of septate uterus that was initially diagnosed by ultrasound scan and confirmed by Magnetic Resonance Imaging (MRI) technique. Keywords: Septate uterus; Mullarian ducts; Ultrasound; MRI Case Report A 29 year old lady came to the imaging diagnostic center of Ahvaz Introduction Oil Grand Hospital.
    [Show full text]
  • Female Infertility: Ultrasound and Hysterosalpoingography
    s z Available online at http://www.journalcra.com INTERNATIONAL JOURNAL OF CURRENT RESEARCH International Journal of Current Research Vol. 11, Issue, 01, pp.745-754, January, 2019 DOI: https://doi.org/10.24941/ijcr.34061.01.2019 ISSN: 0975-833X RESEARCH ARTICLE FEMALE INFERTILITY: ULTRASOUND AND HYSTEROSALPOINGOGRAPHY 1*Dr. Muna Mahmood Daood, 2Dr. Khawla Natheer Hameed Al Tawel and 3 Dr. Noor Al _Huda Abd Jarjees 1Radiologist Specialist, Ibin Al Atheer hospital, Mosul, Iraq 2Lecturer Radiologist Specialist, Institue of radiology, Mosul, Iraq 3Radiologist Specialist, Ibin Al Atheer Hospital, Mosu, Iraq ARTICLE INFO ABSTRACT Article History: The causes of female infertility are multifactorial and necessitate comprehensive evaluation including Received 09th October, 2018 physical examination, hormonal testing, and imaging. Given the associated psychological and Received in revised form th financial stress that imaging can cause, infertility patients benefit from a structured and streamlined 26 November, 2018 evaluation. The goal of such a work up is to evaluate the uterus, endometrium, and fallopian tubes for Accepted 04th December, 2018 anomalies or abnormalities potentially preventing normal conception. Published online 31st January, 2019 Key Words: WHO: World Health Organization, HSG, Hysterosalpingography, US: Ultrasound PID: pelvic Inflammatory Disease, IV: Intravenous. OHSS: Ovarian Hyper Stimulation Syndrome. Copyright © 2019, Muna Mahmood Daood et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Dr. Muna Mahmood Daood, Dr. Khawla Natheer Hameed Al Tawel and Dr. Noor Al _Huda Abd Jarjees. 2019. “Female infertility: ultrasound and hysterosalpoingography”, International Journal of Current Research, 11, (01), 745-754.
    [Show full text]
  • Management of Reproductive Tract Anomalies
    The Journal of Obstetrics and Gynecology of India (May–June 2017) 67(3):162–167 DOI 10.1007/s13224-017-1001-8 INVITED MINI REVIEW Management of Reproductive Tract Anomalies 1 1 Garima Kachhawa • Alka Kriplani Received: 29 March 2017 / Accepted: 21 April 2017 / Published online: 2 May 2017 Ó Federation of Obstetric & Gynecological Societies of India 2017 About the Author Dr. Garima Kachhawa is a consultant Obstetrician and Gynaecologist in Delhi since over 15 years; at present, she is working as faculty at the premiere institute of India, prestigious All India Institute of Medical Sciences, New Delhi. She has several publications in various national and international journals to her credit. She has been awarded various national awards, including Dr. Siuli Rudra Sinha Prize by FOGSI and AV Gandhi award for best research in endocrinology. Her field of interest is endoscopy and reproductive and adolescent endocrinology. She has served as the Joint Secretary of FOGSI in 2016–2017. Abstract Reproductive tract malformations are rare in problems depend on the anatomic distortions, which may general population but are commonly encountered in range from congenital absence of the vagina to complex women with infertility and recurrent pregnancy loss. defects in the lateral and vertical fusion of the Mu¨llerian Obstructive anomalies present around menarche causing duct system. Identification of symptoms and timely diag- extreme pain and adversely affecting the life of the young nosis are an important key to the management of these women. The clinical signs, symptoms and reproductive defects. Although MRI being gold standard in delineating uterine anatomy, recent advances in imaging technology, specifically 3-dimensional ultrasound, achieve accurate Dr.
    [Show full text]
  • Midwifery & Women's Health Nurse Practitioner Certification Review
    MIDWIFERY & WOMEN’S HEALTH NURSE PRACTITIONER CERTIFICATION REVIEW GUIDE Second Edition Edited by Beth M. Kelsey, EdD, WHNP-BC Assistant Professor School of Nursing Ball State University Muncie, Indiana Board of Directors National Association of Nurse Practitioners in Women’s Health (NPWH) Washington, DC 74172_FMXx_ttlpg.indd 1 7/30/10 2:53 PM World Headquarters Jones & Bartlett Learning Jones & Bartlett Learning Jones and Bartlett Learning 40 Tall Pine Drive Canada International Sudbury, MA 01776 6339 Ormindale Way Barb House, Barb Mews 978-443-5000 Mississauga, Ontario L5V 1J2 London W6 7PA [email protected] Canada United Kingdom www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to [email protected]. Copyright © 2011 by Jones & Bartlett Learning, LLC All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described.
    [Show full text]
  • 6Th I-DSD Symposium Programme. 29Th June – 1St July 2017, Copenhagen, Denmark
    6th I-DSD Symposium Programme. 29th June – 1st July 2017, Copenhagen, Denmark Abstracts Session 1 – Setting The Scene “Stuck in the middle” Eric Vilain MD PhD For families, the birth of a child with a Disorder/Difference of Sex Development (DSD), and uncertainty about the child’s gender and future psychosocial development, is believed to be very stressful. Potential stressors include the parents’ need to gather medical information, make decisions about gender assignment and surgical interventions, cope with medical treatments and the possibility of multiple operations, and handle familial strains related to the perceived stigma of DSD. These stressors are amplified by a large number of uncertainties in the management of DSD. I will review the current uncertainties in the world of DSD (naming, diagnosis, gender, genital surgery, disclosure, fertility, outcomes) and discuss how I have attempted to navigate the waters –often troubled- flowing between the different stakeholders involved with DSD. Session 2 – International Collaborations & Moving Forward The needs of people with conditions affecting sex development Joanne Hall (CLIMB CAH Group) Joanne is a mother of two daughters with salt wasting Congenital Adrenal Hyperplasia and is a member of the UK based CAH support group. Joanne represents the support group at European COST Action meetings and through this recently co-ordinated a European based patient/parent workshop, primarily to engage with professionals and discuss what has worked and has not worked with patient care from childhood through to adulthood. Using learning from this workshop, along with her personal and professional experience of working with families and facilitating groups, Joanne hopes to provide information and practical guidance for professionals to engage with parents and patients, in order to find out what the needs are for people affected by conditions of sexual development within the professional’s own local clinical setting.
    [Show full text]
  • Uterus Didelphys with Longitudinal Vaginal Septum: Normal Delivery Chandrakala Magudapathi* Department of Obstetrics and Gynaecology, G
    ical C lin as C e Magudapathi, J Clin Case Rep 2012, 2:13 f R o l e DOI: 10.4172/2165-7920.1000194 a p n o r r t u s o J Journal of Clinical Case Reports ISSN: 2165-7920 Case Report Open Access Uterus Didelphys with Longitudinal Vaginal Septum: Normal Delivery Chandrakala Magudapathi* Department of Obstetrics and Gynaecology, G. Kuppuswamy Naidu Memorial Hospital, Nethaji road, Coimbatore, India Keywords: Uterus didelphys; Vaginal delivery Diagnosis is mainly by pelvic examination – double vagina and double cervix. Introduction Investigations include transvaginal sonography. 3D is an excellent Pregnancy in uterine didelphys is a relatively rare condition and non invasive method [2]. Others include- Sonohysterography, the mode of delivery in these patients is unclear. Uterine didelphys Hysterosalpingography, MRI and Hysterolaparoscopy. is not an indication for caesarean section. We report a case of uterus didelphys who had a vaginal delivery. Pregnancy losses, Malpresentations, IUGR are some of the complications during pregnancy. Case Report Incidence of caesarean section is 82% [3] Herlyn-Werner- A 21 year old, Rhesus negative Primigravida referred in view of Wunderlich syndrome- a rare syndrome described is an association of severe preeclampsia with uterine didelphys. She had regular cycles and uterine didelphys with haematocolpos and ipsilateral renal agenesis [4]. no history of menstrual disturbances in the past. She was married for 10 months, spontaneous conception and no dyspareunia. Booked at Multiple pregnancies are very rare. The usual presentation is 6weeks, had conceptional folate, Iron and calcium supplementation. twins in each horn separately. Majority of Multiple pregnancies with No history of early pregnancy bleeding or threatened preterm labour.
    [Show full text]
  • Pregnancy in Uterus Didelphys Delivered by Caesarean Delivery: Case Report
    International Journal of Reproduction, Contraception, Obstetrics and Gynecology Rao SS et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jul;5(7):2434-2437 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162143 Case Report Pregnancy in uterus didelphys delivered by caesarean delivery: case report Sneha S. Rao, Anitha GS*, Chandralekha P. Department of Obstetrics and Gynaecology, ESIPGIMSR, Bangalore, Karnataka, India Received: 26 April 2016 Accepted: 02 June 2016 *Correspondence: Dr. Anitha GS, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Uterus didelphys represents a uterine malformation where the uterus is present as paired organ. There is presence of double uterine bodies with two separate cervices and often a double or septate vagina. Women with congenital malformations of uterus usually have higher incidence of complications during pregnancy and delivery. We report the case in our institute of a pregnancy in the left sided body of a didelphys uterus delivered by caesarean section. Keywords: Uterine didelphys, Caesarean delivery, Mullerian duct INTRODUCTION Mullerian duct anomalies are congenital anomalies of the Unicornuate and didelphys uterus have term delivery female genital tract arising from abnormal embryological rates of ∼45%, and the pregnancy outcome of patients development of the mullerian ducts. These abnormalities with untreated bicornuate and septate uterus is also poor can include failure of development, fusion, canalization, with term delivery rates of only ∼40%.4 Arcuate uterus is or reabsorption, which normally occurs between 6 and 22 associated with a slightly better but still impaired weeks in utero.
    [Show full text]
  • Incidence of Congenital Uterine Malformation in Fertile Female
    International Journal of Reproduction, Contraception, Obstetrics and Gynecology Srivastava D et al. Int J Reprod Contracept Obstet Gynecol. 2020 Apr;9(4):1398-1401 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201006 Original Research Article Incidence of congenital uterine malformation in fertile female population undergoing laparoscopic tubal ligation at a tertiary care centre, Lucknow, Uttar Pradesh, India: a study of six years 1 2 Deepali Srivastava , Sandeepa Srivastava * 1Department of Obstetrics and Gynecology, KGMU, Lucknow, Uttar Pradesh, India 2Consultant Gynecologist, RMLIMS, Lucknow, Uttar Pradesh, India Received: 26 January 2020 Revised: 19 February 2020 Accepted: 24 February 2020 *Correspondence: Dr. Sandeepa Srivastava, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Congenital uterine anomalies are not only uncommon, many are asymptomatic. A uterine malformation is a type of female genital malformation resulting from an abnormal development of the mullerian ducts during embryogenesis. The prevalence of uterine malformation is estimated to be 6.7% in general population. Methods: This study has included 2423 women who attended family planning OPD in KGMU for purpose of laparoscopic tubal ligation along with general and systemic examination. During the laproscopic ligation procedure the observed uterine anomalies were noted and compared to the data available in the existing medical literature. Results: Out of 2423 females included in this study during 2011-2016, 104 (4.29%) females were diagnosed with uterine anomalies.
    [Show full text]
  • Congenital Anomalies in the Offspring of Mothers with a Bicornuate Uterus
    Congenital Anomalies in the Offspring of Mothers With a Bicornuate Uterus Marı´a Luisa Martı´nez-Frı´as, PhD*; Eva Bermejo, PhD‡; Elvira Rodrı´guez-Pinilla, MD, PhD‡; and Jaime Luis Frı´as, MD§ ABSTRACT. Background. Most of the reports on ital anomalies in the offspring other than vascular mothers with bicornuate uterus analyze fertility, repro- disruptions and deformations.6,7 To our knowledge, ductive capacity, and pregnancy outcomes. Very few of no previous epidemiologic studies estimating the them, however, mention the risk for congenital anoma- risk for congenital defects and analyzing the type of lies in their offspring. Further, to our knowledge, no anomalies observed in infants born to mothers with epidemiologic studies estimating the risk for congenital a bicornuate uterus have been published. defects and analyzing the type of anomalies observed in infants born to mothers with bicornuate uterus have We present an analysis of the risk for congenital been reported. anomalies in infants of mothers with a bicornuate Methods. Using a case-control study series, we esti- uterus, using a case-control study. We also analyzed mated the risk of congenital anomalies in the offspring the type of congenital defects observed, using a large of women with a bicornuate uterus. To identify the spe- sample of malformed infants from a series of consec- cific defects associated with the presence of a bicornuate utive births. uterus in the mother, we analyzed 26 945 consecutive malformed infants from the Spanish Collaborative Study MATERIALS AND METHODS of Congenital Malformations and assessed the frequency Data were derived from the Spanish Collaborative Study of of congenital anomalies in the offspring of mothers with Congenital Malformations (ECEMC).
    [Show full text]
  • Uterine Structural Anomalies and Arthrogryposisdeath of an Urban Legend
    RESEARCH ARTICLE Uterine Structural Anomalies and Arthrogryposis—Death of an Urban Legend Judith G. Hall* Departments of Medical Genetics and Pediatrics, University of British Columbia and BC Children’s Hospital, Vancouver, British Columbia, Canada Manuscript Received: 18 April 2012; Manuscript Accepted: 23 August 2012 In a review of 2,300 cases of arthrogryposis collected over the last 35 years, 33 cases of maternal uterine structural anomalies were How to Cite this Article: identified (1.3%). These cases of arthrogryposis represent a very Hall JG. 2013. Uterine structural anomalies heterogeneous group of types of arthrogryposis. Over half of and arthrogryposis—Death of an urban individuals affected with arthrogryposis demonstrated asymme- legend. try and some responded to removal of constraint, 29 of the 33 Am J Med Genet Part A 161A:82–88. cases of arthrogryposis whose mother had a uterine structural anomaly could be identified as having a specific recognizable type of arthrogryposis. Only two cases (0.08%) had primarily prox- imal contractures that returned to almost normal function within the uterus, intrauterine vascular compromise, maternal within 1 year. Craniofacial asymmetry was the most striking illness and exposure to specific drugs or medications. Once fetal finding in these two cases. A quarter of cases had ruptured akinesia occurs, contractures at involvedjoints begin to develop, the membranes between 32 and 36 weeks and either oligohydram- longer the decreased fetal movement, the more severe the limitation nios or prematurity. The pregnancy histories of the mothers with of joint movement and the more likely that pterygia or constraining uterine structural anomalies were typical in having infertility, connective tissue will develop around the joint [Hall, 2012].
    [Show full text]
  • OHVIRA Syndrome): a Rare Case Report Dr
    Scholars International Journal of Obstetrics and Gynecology Abbreviated Key Title: Sch Int J Obstet Gynec ISSN 2616-8235 (Print) |ISSN 2617-3492 (Online) Scholars Middle East Publishers, Dubai, United Arab Emirates Journal homepage: https://saudijournals.com Case Report Uterus Didelphys with Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome): A Rare Case Report Dr. Nighat Sultana1, Prof. Jasmine Banu2, Dr. Shakeela Ishrat3*, Dr. Sadia Afrin Munmun4, Dr. Mahamuda Yasmin5, Dr. Dilruba Akhter6 1Consultant, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh 2Professor, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh 3Associate Professor, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh 4Consultant, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh 5Consultant, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh 6Consultant, Dept. of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka Bangladesh DOI: 10.36348/sijog.2021.v04i06.005 | Received: 17.05.2021 | Accepted: 24.06.2021 | Published: 27.06.2021 *Corresponding author: Dr. Shakeela Ishrat Abstract The triad of uterine didelphys, obstructed hemivagina and ipsilateral renal anomaly known as OHVIRA syndrome, formerly known
    [Show full text]