(Zhen Dianqiu Cheng Zhigang School) 030 uses silicone ring and spring clip to re-pregnancy after sterilization of the oviduct (English) / The purpose of the study is to determine the risk factors for pregnancy after silicone tube or spring clip tubal sterilization. Sterilization by these two methods was first carried out in 1979, and women aged 18-44 years old were performed in medical centers in 9 cities in the United States. Before the sterilization, the medical history was recorded and the surgical procedures were recorded. The telephone was followed up for 1 month, 1 year and 5 years after sterilization, but the sterilization was only performed once in 8-14 years from 1978 to 1983. Follow-up pregnancy and ultrasound or pathological examination to determine intrauterine or ectopic pregnancy, must also determine whether the luteal phase of pregnancy before sterilization and found after sterilization.
~ 1983 and 1985 1987 two years of spring clip sterilization followed up for 5 years analysis and analysis, and analysis of the possibility of re-pregnancy of spring clip and silicone ring sterilization for 1 year. Use the standard life table to estimate the total likelihood of pregnancy, the possibility of pregnancy after sterilization, using C0X proportional hazard analysis and SAS statistics, risk factors related to silicone ring and spring clip application site, applied to the proximal, middle or far of the fallopian tube End 1/3 or these parts are used in combination.
329 cases, 1595 cases of spring clip sterilization, 35 cases of pregnancy in silicone ring sterilization (1.1%), including 25 cases of intrauterine pregnancy, 10 cases of ectopic pregnancy; the total 10 years of possible pregnancy rate varies by age, race or religion Difference: black, non-Latin American women (black 52.3% c; non-Latin America 6.5*) than white or Latin American, American, Indian, Alaska native or Asian, Pacific Island (5.1%; 95% CI0.0) , 12.0; corpse <0.01) people are more likely to re-pregnancy, 5 years after pelvic inflammatory disease (PID) sterilization (24.2%) than those without PID history, the incidence of re-pregnancy is higher (8.6% c, P = 0.04), but the incidence of 10 years after sterilization did not differ between the two groups (P = 0.62). Sterilization with silica gel ring If one side of the tubal sterilization is located at the distal end, the failure rate is higher than that of other sites or joint sites (34.2% c, 5.4%, respectively); the same total failure after 10 years (52 8%c) may be statistically insignificant above the other sites or joint sites (17.1% C). 10 years total pregnancy probability 0. 42. Silicone ring sterilization effect failure related factors: age, race, belief, sterilization site, education, marital status, pregnancy time, PID history, history of abdominal or pelvic surgery, anesthesia method, Adhesive condition, fallopian tube disease and silicone ring were ligated alone at the distal end of the fallopian tube. For example, the combined operation rate of the three sites was the lowest. For example, if the fallopian tube was ligated to the distal end 1/3, the failure rate increased by 5 times. 1595 cases were sterilized by spring clips, and 48 cases (3.0%) were pregnant, including 41 cases of intrauterine pregnancy and 7 =0.90 of ectopic pregnancy. The overall pregnancy probability varies from age to age in 10 years. Black, non-Latin American 10-year total pregnancy rates are higher than whites (59.5%), non-Latin Americans 11.8% (P<0.001); Latin America , American Indians, Alaska natives or Asians or Pacific Islanders are the most likely to fail (194.2% c) but P = 0.20. Those with tubal lesions are more likely to have a pregnancy after 1 year than those without lesions (117.6) %:16.0%.;P=0.03), there was no significant difference between the two groups during the 10-year follow-up (the risk factors related to the failure of the 5th spring clip and the silicon ring sterilization were basically the same. Whether the clip is clamped to the near heart 1/3. Researcher It is found that the clip is not used for 1/3 of the near heart and is not easy to fail
Conclusion The total pregnancy rate of silicone ring and spring clip sterilization for 10 years is low, but it is important because of clinical and demographic characteristics.
(Zhang Zhumei's 铙 瑾 )) BRCA1 or BRCA2 variant carriers of tubal ligation and ovarian cancer risk: a case-control study [English] / NarodSA... / / carrying BRCA1 or BRCA2 gene mutations women have a lifelong risk of ovarian cancer (respectively 40% or 25% or so). If the ovarian cancer cluster women carry this variant gene, the incidence of ovarian cancer is higher.
Some prospective case-control studies have shown that tubal ligation is associated with a reduced risk of ovarian cancer. However, to date, there is no related study on whether tubal ligation is associated with a reduced risk of ovarian cancer in BRCA1 and BRCA2 variant gene carriers. To this end, the authors conducted a case-control study to assess this relationship.
Methods Data from patients with BRCA deletion mutations were obtained from 30 centers in Canada, the United States, and the United Kingdom. All patients completed the questionnaire (including family history, birth history and medical history and lifestyle, especially whether tubal ligation, age at the time of ligation, oral contraceptive use (0C)). Patients diagnosed with invasive ovarian cancer or tubal ligation were identified, and all cases that were difficult to diagnose were excluded. All patients had a non-ovarian cancer patient matched with age, country of residence, race, and BRCA variant (BRCA1 or BRCA2) as controls.
The median age of 232 patients diagnosed with ovarian cancer was 51 (24-81) years. Among them, 173 had BRCA1 mutation and 59 had BRCA2 mutation; the control group had the same BRCA variation distribution as the case group. Thirty-seven patients and 69 women in the case group and the control group underwent tubal ligation.
Uncorrected statistical analysis showed that patients with ovarian cancer carrying the BRCA1 variant gene had significantly fewer tubal ligation than non-ovarian cancer controls carrying the BRCA1 variant (3,173,18% vs. 60/173,35%; The odds ratio (OR) was 0.37, 95% CIO.21-0.63; cadaver=0.0003. After correlation with 0C, parity, breast cancer personal history and ethnicity, this correlation was still significant. The OR was 0.39 (P=0.002), but the tubal ligation of the BRCA2 variant gene did not have this protective effect.
The results also showed that 0C also had a strong anti-ovarian cancer effect (OR 0.44, 95% CI 0.28-0.68). The significance of this result was not only found in BRCA1 but also in BRCA2 carriers (OR 0.48, 80 and 0.35, 95% CI 0.15 to 0.83, respectively). However, the combined protection of 0C and tubal ligation is far superior to any of the above two methods.
Conclusions The results of this study support the recommendation of women with BRCA1 variant gene to use tubal ligation to reduce the risk of ovarian cancer. Although there are reports of tubal ligation that may have mild menstrual irregularities, this procedure has few side effects.
Given that tubal ligation is associated with a reduced risk of ovarian cancer in women with BRCA1 mutations, the authors believe that tubal ligation should be considered in conjunction with 0C for maximum protection. There are no special recommendations for carriers with BRCA2 mutations, and further research is needed for this population.
(Zhang Chunping, Wang Guirong School) Fetal cells in uterine cervix: a source of early non-traumatic prenatal diagnosis
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