Cervical angle as a possible predictor of abnormal placental position in women with endometriosis.

BACKGROUND: We aimed to examine the effects of endometriosis on the rate of abnormal placentation by comparing the data of pregnant women with and without endometriosis. METHODS: A case-control study was conducted to compare the perinatal outcomes between women with and without endometriosis. In the subgroup analysis, magnetic resonance imaging (MRI) scans of pregnant women with placenta previa were used to measure the cervical angle and its relationship with endometriosis. The cervical angle was measured as the angle between the cervical glands and the line perpendicular to the spinal column in each sagittal MRI section. RESULTS: We retrospectively analyzed data from 3453 cases of singleton deliveries between 2015 and 2019 at two study facilities. Among them, 159 had clinically or surgically confirmed endometriosis. The odds ratio (OR) for abnormal placental position was significantly higher in pregnant women with endometriosis (OR. 2.82; 95% confidence interval [CI], 1.58-5.04). The OR was 3.21 (95% CI, 1.57-6.55) in the endometriosis-surgery group (91 patients) and 2.32 (95% CI, 0.91-5.88) in the non-surgery group (68 patients). Furthermore, 44 women who underwent pelvic MRI after 30 weeks of gestation were included to examine the cervical angle. Then, we compared the date of pregnant women with (n = 6) and without endometriosis (n = 38). Regardless of placental attachment position, the cervical angle was significantly lower in the group with than in the group without a history of endometriosis. CONCLUSION: Pregnant women with a history of endometriosis may have stronger uterine retroversion, which could potentially contribute to abnormal placental positioning.

A Case of Cornual Pregnancy after Ipsilateral Salpingectomy for Isthmic Pregnancy.

The patient was a 32-year-old woman, gravida three, para one with one prior cesarean section. She became pregnant spontaneously, but the pregnancy implanted in the isthmus of the right fallopian tube, and therefore, she underwent laparoscopic right salpingectomy. Eight months later, another spontaneous pregnancy occurred. the patient experienced abdominal pain and an ultrasound examination revealed a hematoma around the right cornual region. A wedge-shaped incision was made in the cornual pregnancy using monopolar cauterization, and the myometrium was sutured with a single nodule suture. We report a case of spontaneous cornual pregnancy after ipsilateral salpingectomy for an isthmic pregnancy.

Live birth by cesarean section after rupture of uterine cornua in simultaneous corneal and intrauterine pregnancies.

A patient became pregnant by in vitro fertilization and embryo transfer (IVF-ET). She had a history of laparoscopic bilateral salpingectomy and enucleation of a left ovarian tumor due to bilateral hydrosalpinx and left endometriotic cyst in primary infertility. She noticed abdominal pain and visited the nearby general hospital by ambulance (gestational age 6 weeks and 1 day). She was admitted to our department because of ascites. An abdominal hemorrhage due to a rupture of the residual corneal segment of the fallopian tube was suspected and emergency laparoscopic surgery was performed. Simultaneous internal and external pregnancy resulted in rupture of the right tubal corneal at the ectopic site of pregnancy. The baby in the uterus grew smoothly and was delivered by cesarean section. This is a report of a case in which live birth after rupture of uterine cornua in simultaneous corneal and intrauterine pregnancies. We searched the literature for similar cases and examined management methods.

Prevalence of rear seat belt use among pregnant women in a suburban area of Japan.

AIM: The aim of this study was to clarify the prevalence and influencing factors of rear seat belt use among pregnant women. METHODS: Questionnaires were given to 1546 pregnant women who visited obstetrics clinics and hospitals for prenatal checkups from October to December 2013. A total of 1494 pregnant women (96.6%) agreed to participate in this study and completed the questionnaire. RESULTS: Fewer than 20% of the rear-seat passengers 'always' used seat belts before and during pregnancy, whereas a third 'never' used a seat belt before or during pregnancy. There was no significant decrease in seat belt use by rear-seat passengers during compared to before pregnancy. Multivariate analysis revealed that age, knowledge of how to use a seat belt during pregnancy, belief in the compulsory use of a rear seat belt and driver behavioral characteristics before pregnancy were associated with rear seat belt use during pregnancy. CONCLUSIONS: The prevalence of fastening seat belts was substantially low. The provision of information regarding proper seat belt use and its role in protecting the fetus may increase use.