Reproductive performance following ectopic pregnancy

350

Citations from the Literature

Dysmenorrhea was alleviated or completely disappeared during therapy. Hot flush was the one mostly complained. Vaginal dryness was the second and decreased libido the third. Persisted periodic bleeding was noted in 3 patients Ovulation was suppressed as evidenced by low serum progesterone throughout the whole course of treatment. Second-look laparoscopy was done at the end of 6-month therapy. Scoring assigned by the American Fertility Society (AFS) was reduced by 27.5%. The adrenal gland, liver and renal functions as well serum calcium and phosphate were retained at the end of treatment. Ovulation and menstruation also returned to normal within 2 months after cessation of therapy. There were 4 pregnancies during the 6-month follow period (Ul5 = 26.6% pregnancy rate). 7 patients had improved symptoms whereas 7 patients sustained recurrent dysmenorrhea. The hormonal profile showed that dysmenorrhea improved group had better ovarian suppression than the dysmenorrhea recurrent group. Reproductive performance following ectopic pregnancy

Shiao-Yih Lee; Jaw-Shong Yan; Hung-Sheng Liu; ChangSheng Yin CHIN MED J 1991 48 (278) The reproductive performance subsequent to operative removal of ectopic pregnancy was examined in 132 women. They represent 44.6% of 296 women admitted for ectopic pregnancy between 1981 and 1989. The follow-up period ranged from 6 months to 9 years, averaging 3.6 years. During the follow-up period, 69 (52.3%) pregnancies occurred. Among them, 60 (87%) were intrauterine and 9 (13”/uof the pregnant women) were repeated ectopic pregnancies. Full-term delivery was obtained in 73.9% of the pregnant patients. Forty of the 132 patients received conservative surgery and 92 patients received radical surgery for ectopic pregnancy. The operation method had no influence on subsequent fertility in women with an intact contralateral tube, who had significantly higher pregnancy (P < 0.005) rate (3.8%) than women with an affected contralateral tube (39.5%, 47% and 41x, respectively). Compared with parous women (13.30/u),the risk of repeated ectopic pregnancy was similar to nulliparous women (12.5%). but the nulliparous women had a slightly lower conception rate (40%) than parous women (54.8%). Unruptured ectopic pregnancies comprised 41.6% of our cases. There was no significant difference in fertility rate between ruptured and unruptured ectopic pregnancies in our study. Clinical diagnosis cervix

in microinvnsive

carcinoma

of the uterine

Wei-Min Liu; Kuan-Chong Chao: Yuen-Yee Kan; ChiouChung Yuan; Chia-Jung Chen; Heung-Tat Ng CHIN MED J 1990 46 (167) This retrospective study collected the surgical tissues and the clinical records of 197 surgically treated patients with microinvasive carcinoma of the cervix, which was defined as a limited microinvasion not more than 3 mm in depth regardless of lymph-vascular involvement. Depth of invasion was I mm or less in 13.2% and 1.1 to 3 mm in 86.8%. The mean age was 47.2 years. About half of the patients were asymptomatic but Int J Gynecol Obsret 43

suspected cytologically. Random cervical biopsy alone was inadequate for diagnosis. Cone biopsy demonstrated an accuracy of 94”/uin diagnosis, but failed to eliminate microinvascive carcinoma in 23.0% of the hysterectomy specimens. In 14 cases, the invasion was more extensive in the uterus than in the cone. A positive correlation has been found between the diagnostic rate of conization and the depth of stromal invasion. Cervical conization, while relatively accurate in assessing the existence of stromal invasion that characterizes microinvasion, failed to diagnose those with deeper stromal invasion, especially beyond 1 mm. The recommended approach in diagnosing microinvasion is careful colposcope-directed cone biopsy and proper examination of the conization specimen in order to exclude the possibility of more advanced disease. Renal metastases

of choriocarcinoma.

A clinicopathological

study of 31 cases

Yuan-E W; Hong-Zhao S; Xiu-Yu Y; Shu-Ying D; Ning G CHIN MED J 1991 104/9 (716) From 1949 to 1978, 31 patients with renal metastasis were diagnosed in a total of 448 cases of choriocarcinoma admitted to our hospital, giving an incidence of 6.9%. Renal metastasis was invariably preceded by pulmonary metastases and usually accompanied by other visceral metastases, indicating that renal metastasis is the result of dissemination of tumor cells secondarily from lung metastasis through the general circulation and should be categorized as arterial metastasis. Pyelogram is useful in the presence of medullary invasion by the tumor, Renal metastatic tumors are very sensitive to chemotherapy. Good response to chemical agents may be due to high drug concentration attained in the kidney tissue during excretion. Since successful treatment of renal metastasis by chemotherapy alone may be obtained. patients can be spared a major operation without jeopardizing the prognosis, Chemotherapy of advanced breast cancer under guidance of cbemosensitivity test (SRC assay)

Ning L-S; Hu Z-Z CHIN J CLIN ONCOL 1991 IISUPPL. (300) From Oct. 1986 to Dec. 1987. 24 patients with advanced breast cancer were treated by chemotherapy under the guidance of tumor response to chemotherapeutic agents with a 6-day subrenal capsule (SEC) assay. Among 22 evaluable cases, 14 cases were treated with single drug and 8 cases with combined agents. According to WHO’s criterion for evaluating therapeutic effects, response rate of 64% was achieved in single drug group and 87.5% in combined agents group. which were evidently superior to chemotherapy given empirically. Leiomyosarcoma

of the broad ligament -

report of two cases

Jeen-Forn Lee; Yuh-Cheng Yang; Y&Nan Lee; Kung-Liahng Wang; Yun-Nan Lin CHIN MED J 1991 48 (59) Leiomyosarcoma of the broad ligament (LBL) is a very rare tumor. Up to 1989, there bad been only 7 cases reported in the English literature. During recent 12 years, we have had 15 cases of leiomyosarcoma in our department, Among them, there