Uterine arteriovenous malformation (AVM) is an abnormal connection between arteries and veins within the uterus. Although AVM can be congenital or acquired, this article focuses on the diagnosis and management of acquired AVMs identified following early pregnancy complications. AVMs may develop as a result of damage to the uterine tissue following spontaneous miscarriage, pregnancy termination, dilatation and curettage, caesarean scar pregnancy, or gestational trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
Uterine arteriovenous malformation (AVM) is an abnormal connection
between arteries and veins within the uterus. Although AVM can be
congenital or acquired, this article focuses on the diagnosis and
management of acquired AVMs identified following early pregnancy
complications. AVMs may develop as a result of damage to the uterine
tissue following spontaneous miscarriage, pregnancy termination,
dilatation and curettage, caesarean scar pregnancy, or gestational
trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
The approach in prenatal diagnosis has been revolutionized by advances in prenatal molecular diagnostics. New algorithms in prenatal diagnosis are evolving and becoming increasingly complicated (Figure 1). The goal is to maximize the prenatal information for pregnant women and the families to make choices for the next generations.
Thalassaemia becomes a global health problem. Most women with thalassaemia trait can be picked up by universal prenatal screening for thalassaemia using mean corpuscular volume/haemoglobin, followed by haemoglobin pattern with or without DNA analysis.
The incidence of twins and high-order multiple pregnancies have been increasing over the past decades as a result of the widespread use of assisted reproductive techniques (ART). While multiple gestation rates have increased from 1.93% in 1980 to 3.15% in 2003 in the United States, the global coverage seems to be around 30 per 1,000 births in the past decade.1
The main causes of increased perinatal mortality and morbidity in multiple pregnancies as compared to singletons are preterm delivery and low or extremely low birth weight. Even in those infants that survived, the risk of cerebral palsy and other forms of neurological developmental defects was estimated to be around four times that of singleton pregnancies. The incidence of milder forms of neurological or developmental deficits such as educational difficulties or behavioural problems are even more common in these pregnancies.
Menstrual problems are the commonest gynaecological complaint in adolescent females.The most common menstrual problems seen in paediatric and adolescent gynaecology clinic include dysmenorrhoea, heavy menstrual bleeding, oligomenorrhoea and amenorrhoea.
Infertility is defined as failure to achieve pregnancy after one year of regular unprotected intercourse. It is a significant global problem with a prevalence of approximately 1 in 7 couples.1 Male factor is a common diagnostic category, and as a single factor it accounts for approximately 20% of the infertile couples.2, 3
Pregnancy is a proinflammatory state with activation of endothelial cells while operative delivery and genital tract injury can result in endothelial damage. Venous dilatation and compression of pelvic veins by the gravid uterus encourages venous formation in the lower limbs.
Yu Tse Ka, Philip Pun Ching Ip, Karen Kar Loen Chan, 20160316034350
Cervical cancer is the fourth most common cancer in women in the world and there were about 528,000 new patients and 266,000 deaths in 2012. In Hong Kong, its crude incidence rate dropped from about 14 per 100,000 women in late 1990s to around 10.5 in early 2010s, and is currently the 9th commonest female cancer. (Table 1a and 1b)1 This phenomenon may be attributed to the implementation of cervical smear screening programme. Nevertheless, it remains as the 8-9th leading cause of female cancer death over the last decade and the crude mortality rate rose from its trough at 3.0 per 100,000 women in 2003 to 4.0 in 2011. From these results it is obvious that cervical cancer still poses a threat to women’s health. This article aims to review the causal relationship between human papillomavirus (HPV) and cervical cancer and discuss existing methods that prevent HPV from leading to cervical cancer.
Lower oestrogen levels during menopause is associated with lower risk of breast cancer but higher risk of osteoporosis and potentially Alzheimer’s disease (AD), metabolic syndrome and cardiovascular disease, says an expert.
In patients undergoing caesarean section (CS) or vaginal delivery (VD), the intravenous administration of tranexamic acid (TA) appears to be safe and effective in reducing blood loss and the need for blood transfusion. In addition, it may decrease the occurrence of postpartum haemorrhage (PPH) in CS patients, according to a systematic review and meta-analysis.