Nozomi Ouchi

Recurrence of ovarian endometrioma after laparoscopic excision: Risk factors and prevention

The aim of this study was to assess the cut‐off age of the risk factors for postoperative recurrence of ovarian endometriomas and to evaluate the end‐points of follow‐up after laparoscopic excision of ovarian endometriomas.

Gasless laparoscopically assisted myomectomy using a wound retraction system

Introduction: The purpose of this study was to elucidate the feasibility of gasless laparoscopically assisted myomectomy (LAM) using a wound retraction system. This method treats symptomatic uterine myomas by combining laparoscopy with a mini‐laparotomy to enucleate myoma nodules and to close the uterine myometrium.

Lateral axillary nerve palsy as a complication of labor

The physiologic changes of pregnancy, labor and puerperium increase the maternal risk of neuromuscular complications [1]. Acquired compression neuropathy and radiculopathy may occur during pregnancy and delivery [1–3]. For example, Roubal et al. [3] suggested that inappropriate use of a birthing bar during labor can lead to compression of the radial nerve at the level of the spiral groove. There have not been any reports in the literature of bilateral or unilateral nerve palsies associated with maternal birthing position. A 36-year-old woman, gravida 1, para 0, was admitted to our hospital at 38 weeks’ gestation due to uterine contraction. Physical examination on admission was unremarkable, and the fetal heart rate was reassuring. Amniotomy and oxytocin augmentation was initiated for active-phase arrest when she was dilated 8 cm, and the patient progressed to complete dilation shortly thereafter. Throughout the first hour of the second stage, she lay on her right side in bed as shown in Figure 1. Finally, she spontaneously delivered in an upright position a male fetus weighing 2,496 g with Apgar scores of 9 and 9 at 1 and 5 minutes, respectively. The second stage of labor lasted about 1.5 hours. Within approximately 2 hours after the delivery, the patient noticed that she could not bend the right elbow. At this time, she did not complain of any pain or tenderness in her arm, and there were no sensory or other motor deficits. Next morning, she was diagnosed as having right axillary nerve palsy based on nerve conducting velocity studies. She was prescribed 1,500 mg mecobalamin daily. Three weeks later, however, her condition was virtually unchanged. To our knowledge, this is the first reported case of lateral axillary nerve palsy as a complication of delivery associated with maternal birthing position. The current complication is supposed to be attributed to the continued pressure on the axillary nerve due to the continued lateral birth position. Recently, the routine use of the supine position has been considered an intervention in the normal course of labor [4]. Based on the current study, care may be needed to accommodate some maternal positions and to aid the patient in changing positions without maintaining a single position. Figure 1. The maternal position of the patient during labor.

Diversity of progesterone action on lipopolysaccharide-induced expression changes in cultured human cervical fibroblasts according to inflammation and treatment timing

The effectiveness of progesterone (P4) treatment for preventing preterm births is unclear. Its effects on the uterine cervix were tested using cultured human uterine cervical fibroblasts (UCFs).