The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform

Yong Beom Kim - One of the best experts on this subject based on the ideXlab platform.

  • aspiration biopsy versus Dilatation and Curettage for endometrial hyperplasia prior to hysterectomy
    Diagnostic Pathology, 2021
    Co-Authors: Woo Yeon Hwang, Dong Hoon Suh, Kidong Kim, Yong Beom Kim
    Abstract:

    To compare the diagnostic accuracy of aspiration biopsy and Dilatation and Curettage (DC P = 0.008). In particular, significantly fewer patients were upgraded after DC P = 0.028). In addition, when the final pathological upgrade rate to endometrial carcinoma was evaluated between the two methods of endometrial sampling, significantly fewer cases were noted after DC P = 0.022). In our study, D&C more accurately reflected the final diagnosis in patients with endometrial hyperplasia than aspiration biopsy based on the histological examination of hysterectomy specimens. When considering the management strategy for women with an endometrial hyperplasia diagnosis obtained by aspiration biopsy, physicians should consider the significant rate of upgraded diseases with this method of endometrial sampling.

Angelo B Hooker - One of the best experts on this subject based on the ideXlab platform.

  • reproductive performance of women with and without intrauterine adhesions following recurrent Dilatation and Curettage for miscarriage long term follow up of a randomized controlled trial
    Human Reproduction, 2020
    Co-Authors: Angelo B Hooker, Robert De Leeuw, Jos W R Twisk, Hans A M Brolmann, Judith A F Huirne
    Abstract:

    Study question Are the long-term reproductive outcomes following recurrent Dilatation and Curettage (DC fewer ongoing pregnancies and live births are achieved with a prolonged time to a live birth. What is known already The Prevention of Adhesions Post Abortion (PAPA) study showed that application of auto-crosslinked hyaluronic acid (ACP) gel, an absorbable barrier in women undergoing recurrent DC 13/24 (54%) with versus 75/89 (84%) without IUAs, OR 0.22 (95% CI: 0.08 to-0.59, P-value 0.004). The median time to conception was 7 months in women with identified and treated IUAs versus 5 months in women without IUAs (hazard ratio (HR) 0.84 (95% CI 0.54 to 1.33)) and time to conception leading to a live birth 15 months versus 5.0 months (HR 0.54 (95% CI: 0.30 to 0.97)). In women with identified and treated IUAs, premature deliveries were recorded in 3/16 (19%) versus 4/88 (5%) in women without IUAs, P-value 0.01. Complications were recorded in respectively 12/16 (75%) versus 26/88 (30%), P-value 0.001. No differences were recorded in mean birth weight between the groups. Limitations, reasons for caution In the original PAPA study, randomization was applied for ACP gel application. Comparing women with and without IUAs is not in line with the randomization and therefore confounding of the results cannot be excluded. IUAs, if visible during routine hysteroscopy after randomization were removed as part of the study protocol; the influence of IUAs on reproductive outcome may therefore be underestimated. Women undergoing a recurrent D&C for miscarriage were included, a specific group likely to generate clinically significant adhesions. The findings should therefore not be generalized to all women undergoing D&C for miscarriage. Wider implications of the findings As IUAs have an impact on reproductive performance, even after hysteroscopic adhesiolysis, primary prevention is essential. Expectative and medical management should therefore be considered as serious alternatives for D&C in women with a miscarriage. In case D&C is necessary, application of ACP gel should be considered. Study funding/competing interest(s) The original PAPA study (NTR 3120) was an investigator initiated study that was funded by the Foundation for scientific investigation in Obstetrics and Gynaecology of the Saint Lucas andreas Hospital (currently renamed OLVG Oost), SWOGA. The syringes containing ACP gel were received from Anika Therapeutics, the manufacturer of Hyalobarrier® Gel Endo. The current follow-up study was also an investigator-initiated study without funding. The funder and sponsor had no role in the design of this follow-up study, data collection, data analysis, data interpretation, trial design, patient recruitment, writing of the report or any aspect pertinent to the study. ABH, RAL, JAFH and JWRT have no conflict to declare. HAMB reports being a member of safety board research Womed. Trial registration number Netherlands Trial Register NTR 3120.

  • prevalence of intrauterine adhesions after the application of hyaluronic acid gel after Dilatation and Curettage in women with at least one previous Curettage short term outcomes of a multicenter prospective randomized controlled trial
    Fertility and Sterility, 2017
    Co-Authors: Angelo B Hooker, M H Emanuel, Robert L De Leeuw, Peter M Van De Ven, Erica A Bakkum, Andreas L Thurkow, Niels E A Vogel, Huib Van Vliet, Marlies Y Bongers, Annelies E M Verdonkschot
    Abstract:

    Objective To examine whether intrauterine application of auto-crosslinked hyaluronic acid (ACP) gel, after Dilatation and Curettage (DC women and assessors blinded prospective randomized trial. Setting University and university-affiliated teaching hospitals. Patient(s) A total of 152 women with a miscarriage of Conclusion(s) Intrauterine application of ACP gel after D&C for miscarriage in women with at least one previous D&C seems to reduce the incidence and severity of IUAs but does not eliminate the process of adhesion formation completely. Future studies are needed to confirm our findings and to evaluate the effect of ACP gel on fertility and reproductive outcomes. Clinical Trial Registration Number NTR 3120.

  • Dilatation and Curettage increases the risk of subsequent preterm birth a systematic review and meta analysis
    Human Reproduction, 2016
    Co-Authors: Marike Lemmers, Marianne A C Verschoor, Angelo B Hooker, Brent C Opmeer, J Limpens, Judith A F Huirne, W M Ankum, B W M Mol
    Abstract:

    STUDY QUESTION Could Dilatation and Curettage (DC 1.42), while for very preterm birth the ORs were 1.69 (95% CI 1.20; 2.38) for <32 weeks and 1.68 (95% CI 1.47; 1.92) for <28 weeks. The risk remained increased when the control group was limited to women with a medically managed miscarriage or induced abortion (OR 1.19, 95% CI 1.10; 1.28). For women with a history of multiple DC 2.76). For spontaneous preterm birth, the OR was 1.44 (95% CI 1.22; 1.69) for a history of D&C compared with no such history. LIMITATIONS, REASONS FOR CAUTION There were no randomized controlled trials comparing women with and without a history of D&C and subsequent preterm birth. As a consequence, confounding may be present since the included studies were either cohort or case-control studies, not all of which corrected the results for possible confounding factors. WIDER IMPLICATIONS OF THE FINDINGS This meta-analysis shows that D&C is associated with an increased risk of subsequent preterm birth. The increased risk in association with multiple D&Cs indicates a causal relationship. Despite the fact that confounding cannot be excluded, these data warrant caution in the use of D&C for miscarriage and termination of pregnancy, the more so since less invasive options are available. STUDY FUNDING/COMPETING INTERESTS This study was funded by ZonMw, a Dutch organization for Health Research and Development, project number 80-82310-97-12066.

Ji Hyun Choi - One of the best experts on this subject based on the ideXlab platform.

  • uterine arteriovenous malformation with repeated vaginal bleeding after Dilatation and Curettage
    Obstetrics & gynecology science, 2019
    Co-Authors: Da Joung Shim, Sang Joon Choi, Ji Min Jung, Ji Hyun Choi
    Abstract:

    Uterine arteriovenous vascular malformation (UAVM) is a disease that causes excessive bleeding. The symptoms do not subside without proper treatment and this can lead to life-threatening situations. The correct diagnosis of UAVM can be complicated if the patient's uterus did not completely discharge everything during abortion (in broader terms, retaining remnants of the products of conception). In this case, Doppler ultrasonography and computed tomography angiography with 3-dimensional rendering were used to analyze the cause of bleeding and provide proper treatment of this patient. Then, uterine artery embolization, Dilatation, and Curettage were performed safely and successfully. The patient no longer had symptoms of vaginal spotting during the planned follow up care. UAVM is uncommon; however, if reproductive-age women show repeated abnormal vaginal bleeding after Dilatation and Curettage, a diagnosis of UAVM must be considered based on the medical history and examination.

Woo Yeon Hwang - One of the best experts on this subject based on the ideXlab platform.

  • aspiration biopsy versus Dilatation and Curettage for endometrial hyperplasia prior to hysterectomy
    Diagnostic Pathology, 2021
    Co-Authors: Woo Yeon Hwang, Dong Hoon Suh, Kidong Kim, Yong Beom Kim
    Abstract:

    To compare the diagnostic accuracy of aspiration biopsy and Dilatation and Curettage (DC P = 0.008). In particular, significantly fewer patients were upgraded after DC P = 0.028). In addition, when the final pathological upgrade rate to endometrial carcinoma was evaluated between the two methods of endometrial sampling, significantly fewer cases were noted after DC P = 0.022). In our study, D&C more accurately reflected the final diagnosis in patients with endometrial hyperplasia than aspiration biopsy based on the histological examination of hysterectomy specimens. When considering the management strategy for women with an endometrial hyperplasia diagnosis obtained by aspiration biopsy, physicians should consider the significant rate of upgraded diseases with this method of endometrial sampling.

Annelies E M Verdonkschot - One of the best experts on this subject based on the ideXlab platform.