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Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

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World Journal of Diabetes 2024年第5期15卷 914-922页

作者： Ying Zhang Teng Li Chao-Yan Yue Yun Liu department of Laboratory Medicine Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200011China department of interventional radiology The People’s Hospital of Weifang CityWeifang 261041Shandong ProvinceChina department of Hematology The People’s Hospital of Weifang CityWeifang 261041Shandong ProvinceChina

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and *** To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM *** The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the obstetrics and gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed *** these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative *** diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic *** Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,*** AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,*** D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can

关键词： Gestational diabetes mellitus D-dimer Hemoglobin Fetal growth restriction Fasting blood glucose

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Uterine artery embolization in association with methotrexate infusion for the treatment of tubal ectopic pregnancy

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Journal of interventional Medicine 2018年第3期1卷 182-187页

作者： Zhi Li Wenjian Xu Bo Hu Mingming Li Jianwei Zhou Caifang Ni department of interventional radiology First Affiliated Hospital of Soochow University department of obstetrics and gynecology Nanjing Maternity and Child Health Care Hospital

Objective To investigate the safety, feasibility, and effectiveness of uterine artery embolization in association with methotrexate(MTX) infusion for the treatment of tubal ectopic pregnancy. Methods Fifty-one patients with tubal ectopic pregnancy were referred for interventional management. All patients received super-selective arteriography of the uterine artery, were infused with 50–100 mg methotrexate(MTX) through a catheter, and underwent embolization of the uterine artery with a gel-foam pledge. Clinical presentation, findings of physical examination, β-HCG values, and the size of the ectopic mass were documented for comparison. The concentration of MTX in blood was evaluated at 0.5, 6, 12, 24, 36, and 48 hours after the procedure. Results Forty-seven out of the 51 patients had clinical resolution of their tubal pregnancy(92.2%). The average time for the β-HCG value to decrease and come back to normal was 9.16 ± 2.54 days(mean +/-SD). MTX levels in peripheral blood could not be detected for patients who received 50 or 75 mg MTX at 36 hours after the procedure, while the MTX level was 0.01 μmol/L at 48 hours after the procedure for patients who received 100 mg. Out of the 4 cases whose ectopic mass size was ≥5 cm, 3 failed to respond to the treatment; however, those whose ectopic mass size was ≤5 cm responded positively to the treatment, regardless of the β-HCG concentration and abdominal bleeding, except for 1 patient who had to undergo laparoscopy for severe abdominal pain and who showed a reduction in her β-HCG level. Conclusion Uterine artery embolization in association with methotrexate infusion is safe and effective in the treatment of tubal ectopic pregnancy, especially for those women with mild to moderate bleeding, or for those at risk of a major hemorrhage. The selection criterion of mass size >5 cm should, therefore, be carefully considered.

关键词： radiology,interventional tubal,pregnancy embolization,therapeutic

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A Participant-assigned interventional Research of Precesarean Internal Iliac Artery Balloon Catheterization for Managing Intraoperative Hemorrhage of Placenta Previa and Placenta Accreta Spectrum Disorders After Cesarean Section

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Current Medical Science 2021年第2期41卷 336-341页

作者： Yao FAN Xun GONG Nan WANG Ke-tao MU Ling FENG Fu-yuan QIAO Su-hua CHEN Wan-jiang ZENG Hai-yi LIU Yuan-yuan WU Qiong ZHOU Yuan TIAN Qiang LI Yin XIE Fan-fan LI Meng-zhou HE Rajluxmee Beejadhursing Dong-rui DENG Xiao-yan XU department of gynecology and Obstrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China department of interventional radiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Placenta accreta spectrum disorder (PASD) and placenta previa (PP) are two of the mosthideous obstetric complications which are usually associated with a history of cesarean section(CS). Moreover, women with PASD, PP and/or a cesarean scarred uterus are more likely to haveadverse pregnancy outcomes, including blood transfusion, hysterectomy, pelvic organs damage,postpartum hemorhage, disseminated intravascular coagulation, multi-organ dysfunction syndromeand even maternal or fetal death. This study aimed to investigate the efficacy of precesareaninternal iliac artery balloon catheterization (BC) for managing severe hemorhage caused by PASDand PP with a history of CS. This participant-assigned interventional study was conducted inTongji Hospital. We recruited 128 women with suspected PASD, PP and a history of CS. Womenin the BC group accepted precesarean BC of bilateral internal iliac arteries before the scheduledcesarean delivery. Women in the control group underwent a conventional cesarean *** hemorrhage, transfusion volume, radiation dose, exposure time, complicationsand neonatal outcomes were discussed. There were significant differences in calculated bloodloss (CBL) between BC group and control group (1015.0±144.9 vs. 1467.0±171.0 mL, P=0.04).Precesarean BC could reduce intraoperative red blood cell (RBC) transfusion as compared withcontrol group (799.5±136.1 vs. 1286.0±161.6 mL, P=0.02) and lessen the rate of using bloodproducts (57.1% vs. 76.4%, P=0.02). The incidence of hysterectomy was also lower in BC groupthan in control group. Postpartum outcomes showed no significant differences between the twogroups, except that postoperation hospitalization was longer in BC group than in control group(6.7±0.4 vs. 5.8±0.2 days, P=0.03). Precesarean BC of internal iliac artery is an effective methodfor managing severe hemorrhage caused by PASD and PP with a cesarean scarred uterus, as it couldreduce intraoperative blood loss, lessen intraoperative RBC

关键词： nitrosamine cotinine urinary sodium excretion nutrient intake blood pressure

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Diffusion-weighted and diffusion-tensor imaging of normal and diseased uterus

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World Journal of radiology 2015年第7期7卷 149-156页

作者： Duygu Kara Bozkurt Murat Bozkurt Mehmet Ali Nazli Ilhan Nahit Mutlu Ozgur Kilickesmez Depatment of radiology School of Medicine Kafkas University Depatment of obstetrics and gynecology School of Medicine Kafkas University department of Diagnostic and interventional radiology Istanbul Training and Research Hospital

Owing to technical advances and improvement of the software, diffusion weighted imaging and diffusion tensor imaging(DWI and DTI) greatly improved the diagnostic value of magnetic resonance imaging(MRI) of the pelvic region. These imaging sequences can exhibit important tissue contrast on the basis of random diffusion(Brownian motion) of water molecules in tissues. Quantitative measurements can be done with DWI and DTI by apparent diffusion coefficient(ADC) and fractional anisotropy(FA) values respectively. ADC and FA values may be changed by various physiological and pathological conditions providing additional information to conventional MRI. The quantitative DWI assists significantly in the differentiation of benign and malignant lesions. It can demonstrate the microstructural architecture and celluler density of the normal and diseased uterine zones. On the other hand, DWI and DTI are useful for monitoring the treatment outcome of the uterine lesions. In this review, we discussed advantages of DWI and DTI of the normal and diseased uterus.

关键词： Magnetic resonance imaging Diffusion weighted imaging Diffusion tensor imaging Uterus

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Percutaneous needle decompression in treatment of malignant small bowel obstruction

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World Journal of Gastroenterology 2015年第8期21卷 2467-2474页

作者： Ting-Hui Jiang Xian-Jun Sun Yue Chen Hui-Qin Cheng Shi-Ming Fang Hao-Sheng Jiang Yan Cao Bing-Yan Liu Shao-Qiu Wu Ai-Wu Mao interventional Center St. Luke’s Hospital of Jiaotong University School of Medicine department of radiology Renji Hospital of Shanghai Jiaotong University School of Medicine Yangpu Daqiao Community Healthy service Center

AIM:To investigate the efficacy and safety of percutaneous needle decompression in the treatment ofmalignant small bowel obstruction(MSBO).METHODS:A prospective analysis of the clinical data of 52 MSBO patients undergoing percutaneous needle decompression was ***:Percutaneous needle decompression was successful in all 52 *** significant differences were observed in symptoms such as vomiting,abdominal distension and abdominal pain before and after treatment(81.6%vs 26.5%,100%vs 8.2%,and 85.7%vs 46.9%,respectively;all P<0.05).The overall significantly improved rate was 19.2%(11/52)and the response rate was 94.2%(49/52)using decompression combined with nasal tube placement,local arterial infusion of chemotherapy and nutritional *** the one-month follow-up period,puncture-related complications were ***:Percutaneous needle intestinal decompression is a safe and effective palliative treatment for MSBO.

关键词： Arterial infusion chemotherapy Malignant small bow

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Pseudoaneurysm after abdominal myomectomy: A rare but catastrophic complication

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Open Journal of obstetrics and gynecology 2013年第1期3卷 123-125页

作者： May-Tal Sauerbrun-Cutler Jason Kanos Adie Friedman Sarah Bernstein department of interventional radiology St. Luke’s Roosevelt Hospital Center New York USA department of obstetrics and gynecology St. Luke’s Roosevelt Hospital Center New York USA department of obstetrics Gynecology & Reproductive Sciences University of Pittsburgh Pittsburgh USA

Background: Uterine artery pseudoaneurysm is a rare diagnosis made postoperatively after pelvic surgery. The exact etiology is unknown however it is speculated to occur when an artery is lacerated and the perivascular tissue maintains persistent blood flow with the parent vessel. It can present with severe hemorrhage two to four weeks after an uncomplicated post operative course. Case: A 45 year old presented with vaginal hemorrhage and hypotension two weeks after abdominal myomectomy. Transvaginal ultrasound with doppler diagnosed pseudoaneurysm of the uterine artery. The patient was successfully treated with endovascular embolization utilizing micro coils. Conclusion: Transvaginal ultrasound is a useful technique in diagnosing pseudoaneurysms. Endovascular embolization is a minimally invasive, safe and effective way to treat this rare complication in institutions that have access to interventional radiology procedures.

关键词： Myomectomy Pseudoaneurysm Ultrasound

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Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy

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World Journal of Nephrology 2020年第2期9卷 33-42页

作者： Mohamed M Soliman Debkumar Sarkar Ilya Glezerman Majid Maybody interventional radiology service Memorial Sloan Kettering Cancer CenterNew YorkNY 10065United States department of Medicine Memorial Sloan Kettering Cancer CenterNew YorkNY 10065United States

BACKGROUND Contrast-induced nephropathy(CIN)is a reversible form of acute kidney injury that occurs within 48-72 h of exposure to intravascular contrast *** is the third leading cause of hospital-acquired acute kidney injury and accounts for 12%of such *** factors for CIN development can be divided into patientand *** former includes pre-existing chronic renal insufficiency and diabetes *** latter includes high contrast volume and repeated exposure over 72 *** incidence of CIN is relatively low(up to 5%)in patients with intact renal ***,in patients with known chronic renal insufficiency,the incidence can reach up to 27%.AIM To examine the association between renal enhancement pattern on non-contrast enhanced computed tomographic(CT)images obtained immediately following hepatic artery embolization with development of *** Retrospective review of all patients who underwent hepatic artery embolization between 01/2010 and 01/2011(n=162)was *** without intraprocedural CT imaging(n=51),combined embolization/ablation(n=6)and those with chronic kidney disease(n=21)were *** study group comprised of 84 patients with 106 *** was defined as 25%increase above baseline serum creatinine or absolute increase≥0.5 mg/dL within 72 h ***-embolization CT was reviewed for renal enhancement patterns and presence of renal artery *** association between noncontrast CT findings and CIN development was examined by Fisher’s Exact *** CIN occurred in 11/106(10.3%)procedures(Group A,n=10).The renal enhancement pattern in patients who did not experience CIN(Group B,n=74 with 95/106 procedures)was late excretory in 93/95(98%)and early excretory(EE)in 2/95(2%).However,in Group A,there was a significantly higher rate of EE pattern(6/11,55%)compared to late excretory pattern(5/11)(P<0.001).A significantly higher percentage of patients that developed CIN had re

关键词： Hepatic artery embolization Non-contrast computed tomographic Contrastinduced nephropathy Renal enhancement pattern Intra-arterial Renal artery calcification

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Uterine Arteriovenous Malformation Acquired after Cesarean Section: A Case Report

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Open Journal of obstetrics and gynecology 2021年第11期11卷 1512-1516页

作者： Ana Lúcia Isotton Leandro Armani Scaffaro Ellen Machado Arlindo Anne Bergmann Nicolas Karpouzas Vicentini Janete Vettorazzi service of obstetrics and gynecology and interventional radiology department Hospital Moinhos de Vento Porto Alegre Por-to Alegre/RS Brazil Medicina Fetal Porto Alegre Porto Alegre/RS Brazil Post Graduation Program in Health Sciences: gynecology and obstetrics Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS) RS Brazil

Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is an efficacious and effective method of treating AVM, particularly in patients of reproductive age. Case Report: A 41-year-old, nulliparous woman, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications. Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a sa

关键词： Arteriovenous Malformation Embolization Therapeutic Vaginal Bleeding Cesarean Section

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Diagnostic　and　Therapeutic　Radiological　Intervention　for　Fallopian　Tube　Obstruction

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1996年第3期16卷 168-172页

作者：李红发李红霞叶怀英杨健勇詹晓星冯敢生 department of gynecology and obstetrics Xiehe Hospital Tongji Medical University Wuhan department of gynecology and obstetrics Central Hospital of Bridge Bureau Wuhan department of radiology Xiehe Hospital Tongji Medical University Wuhan

Presented in this paper are results of diagnostic and therapeutic radiological intervention for 110 cases of fallopian tube obstruction. Unilateral or bilateral recanalization was achieved in 89 cases, with a success rate being 80. 91%.Among the 89 patients, patency was achieved by first step treatment(regularHSG) in 40 cases (46%) and recanalization was successeful in 49 patients(54%) by sencond and/or third step (selective salpingography plus guide wire). Inthe 49 cases, 96 occluded tubes were involved, including 89 tubes with proximalobstruction (interstitia-isthmus portion) and 7 tubes with medial-distal obstruction (isthmus-ampulla portion). The success rates for proximal and medial-distalobstruction were 92. 2% and 7. 8% respectively. Follow-up results of 45 casesrevealed that the tubes of remained patent in 30 cases; 40 became pregnant, among them, 9 gave normal birth of babies; occlusion re-developed in only onecase. The authors believe that this radiological intervention can avoid false positive findings frequently occurring with use of regular HSG, thereby enhancing diagnostic accuracy. The selective salpingography could directly increase the intratubal hydrostatic pressure , remove the debris and amiliorate the inflammatoryadhersion in the fallopian tubes; selective salpingography plus guide wire recanalization can recanalize the tubes with proximal obstruction with satisfactory results. We recommend the method for the pre-treatment of 'test tube baby' procedure.

关键词： interventional radiology diagnosis, treatment, fallopian tube obstruction

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Routine prenatal ultrasonography: The pregnant woman’s expectations and perspectives on safety in a Central African obstetric population

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Open Journal of obstetrics and gynecology 2013年第7期3卷 573-576页

作者： Joshua Tambe Boniface Moifo Odile Fernande Zeh Pascal Foumane Joseph Gonsu Fotsin Robinson Enow Mbu obstetrics and gynecology department Faculty of Medicine and Biomedical Sciences The University of Yaounde 1 Yaounde Cameroon obstetrics and gynecology department Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon radiology department Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon

Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Objective: To assess the pregnant woman’s expectations during routine prenatal US scan and her perspective ofUSsafety during pregnancy in a Central African obstetric population. Methods: A cross-sectional descriptive survey of consenting pregnant women who reported for routine prenatal US scan using an anonymous questionnaire. A convenient sample of 200 participants was adopted. Results: Thirty-three (16.8%) respondents (on a total of 196) declared they had never done anUSscan. One hundred and eleven (58.4%) on a total of 190 stated that they had not received any information on what ultrasonography is all about. Before theUSscan the respondents would like to receive information on the aim or purpose of ultrasonography, possible inconveniences or risks, and on how to prepare before the scan. The most reported expectations were assurance of the wellbeing of the fetus (58%), gender determination (44.5%) and information on fetal position (20.5%). Thirty-four respondents considered ultrasonography as not perfectly safe for the mother or the “baby”, with the relevant reasons being the use or production of some potentially harmful “rays”. Conclusion: Pregnant women would want to be assured of the wellbeing of the fetus, the gender and position during routine prenatal US. They however need to be informed of its purpose and safety.

关键词： Routine Prenatal US Expectations US Safety

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