American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Nov 2015
Anatomic variations of pudendal nerve within pelvis and pudendal canal: clinical applications.
The objective of the study was to examine the anatomic variation of the pudendal nerve in the pelvis, on the dorsal surface of the sacrospinous ligament, and in the pudendal canal. ⋯ Great variability exists in pudendal nerve anatomy. Fixation of the pudendal nerve to the dorsal surface of the sacrospinous ligament is a consistent finding; thus, pudendal neuralgia attributed to nerve entrapment may be overestimated. The path of the inferior rectal nerve relative to the pudendal canal may have implications in the development of anorectal symptoms. Improved characterization of the pudendal nerve and its branches can help avoid intraoperative complications and enhance existing treatment modalities for pudendal neuropathy.
-
Am. J. Obstet. Gynecol. · Nov 2015
Multicenter StudyMagnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study.
The purpose of this study was to determine the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis during pregnancy in a multiinstitutional study. ⋯ MRI is useful and reproducible in the diagnosis of suspected acute appendicitis during pregnancy.
-
Am. J. Obstet. Gynecol. · Nov 2015
Comparative StudyLaparoscopic and robot-assisted hysterectomy for uterine cancer: a comparison of costs and complications.
Increasingly, robotic surgery is being used for total hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for uterine cancer. The purpose of this study was to compare the costs and complications among women undergoing robotic and laparoscopic hysterectomy for uterine cancer. ⋯ Despite the considerably greater burden of comorbidities in those undergoing robotic surgery compared with laparoscopy, the former have shorter hospital admissions, a greater rate of lymph node dissection, and similar postoperative morbidity and mortality, albeit at greater total cost.
-
Am. J. Obstet. Gynecol. · Nov 2015
Characterization of the host inflammatory response following implantation of prolapse mesh in rhesus macaque.
We sought to determine the predominant cell type (macrophage, T lymphocyte, B lymphocyte, mast cell) within the area of implantation of the prototypical polypropylene mesh, Gynemesh PS (Ethicon, Somerville, NJ); and to determine the phenotypic profile (M1 proinflammatory, M2 antiinflammatory) of the macrophage response to 3 different polypropylene meshes: Gynemesh PS (Ethicon), and 2 lower-weight, higher-porosity meshes, UltraPro (Ethicon) and Restorelle (Coloplast, Humblebaek, Denmark). ⋯ The host response to mesh consists predominantly of activated, proinflammatory M1 macrophages at 12 weeks postsurgery. However, this response is attenuated with implantation of lighter-weight, higher-porosity mesh. While additional work is required to establish causal relationships, these results suggest a link among the host inflammatory response, mesh textile properties, and clinical outcomes in the repair of pelvic organ prolapse.
-
Am. J. Obstet. Gynecol. · Nov 2015
The association between maternal antioxidant levels in midpregnancy and preeclampsia.
We sought to determine whether midpregnancy antioxidant levels are associated with preeclampsia, overall and by timing of onset. ⋯ Most antioxidants were more strongly associated with early-onset preeclampsia, suggesting that oxidative stress may play a greater role in the pathophysiology of early-onset preeclampsia. Alternatively, reverse causality may explain this pattern. Lutein was associated with both early- and late-onset preeclampsia and may be a promising nutrient to consider in preeclampsia prevention trials, if this finding is corroborated.