Hasil untuk "Gynecology and obstetrics"

Evangelia Vlachodimitropoulou, Tharshini Balasubramaniam, Nadine Shehata et al.

Abstract: Outside of pregnancy, placental growth factor (PlGF), is produced by erythroid cells in typically undetectable levels. In pregnancy, PlGF is strongly expressed by the trophoblast layer covering the placental villi. PlGF levels rise progressively due to placental growth, peak at 28 to 30 weeks gestation, and then slowly decline toward term. Low PlGF has emerged as a powerful diagnostic test for preterm preeclampsia. However, its interpretation in context of sickle cell disease (SCD) is potentially confounded by upregulation of cellular PlGF expression in nonpregnant individuals with SCD, and higher third trimester circulating PlGF levels documented in healthy Black compared with White individuals. Primary objectives were to determine the distribution of PlGF at midtrimester in pregnant individuals with SCD compared with unaffected Black controls and to explore the diagnostic accuracy of PlGF in the context of suspected preeclampsia in pregnancies of individuals with SCD. Secondary objective was to examine the relationship between low PlGF and placental disease in pregnancies of individuals with SCD. Pregnant individuals with SCD at Mount Sinai Hospital in Canada (January 2017 to September 2021) with at least 1 PlGF measurement 20+0 to 35+6 weeks gestation, and pregnant Black controls without SCD with suspected preeclampsia or growth restriction, were included in this retrospective study. Maternal and neonatal outcomes were extracted from medical records. For early-onset, but not late-onset, preeclampsia, a PlGF cutoff of <100 pg/mL demonstrated 100% sensitivity and specificity at 20 to 24 weeks gestation. This study is, to our knowledge, the first to demonstrate the utility of PlGF in predicting early-onset preeclampsia in pregnancies of individuals with SCD, allowing clinicians to anticipate and mitigate adverse pregnancy outcomes.

Valentin von Bornhaupt, Johannes Grün, and Justus Bisten et al.

Whole-brain tractography in diffusion MRI is often followed by a parcellation in which each streamline is classified as belonging to a specific white matter bundle, or discarded as a false positive. Efficient parcellation is important both in large-scale studies, which have to process huge amounts of data, and in the clinic, where computational resources are often limited. TractCloud is a state-of-the-art approach that aims to maximize accuracy with a local-global representation. We demonstrate that the local context does not contribute to the accuracy of that approach, and is even detrimental when dealing with pathological cases. Based on this observation, we propose PETParc, a new method for Parallel Efficient Tractography Parcellation. PETParc is a transformer-based architecture in which the whole-brain tractogram is randomly partitioned into sub-tractograms whose streamlines are classified in parallel, while serving as global context for each other. This leads to a speedup of up to two orders of magnitude relative to TractCloud, and permits inference even on clinical workstations without a GPU. PETParc accounts for the lack of streamline orientation either via a novel flip-invariant embedding, or by simply using flips as part of data augmentation. Despite the speedup, results are often even better than those of prior methods. The code and pretrained model will be made public upon acceptance.

Maciej Wilczynski, Mark Fedorov, Tymofii Khvan et al.

Molecular dynamics (MD) simulations were performed to investigate the influence of mechanical strain on irradiation-induced defect and dislocation evolution in nickel single crystals subjected to cumulative overlapping 5 keV collision cascades at 300 K. The simulations reveal that tensile strain modifies the dynamics of defect generation and recovery, promoting stress-assisted defect mobility and enhancing defect survival compared to the unstrained case. The heat spike duration and intensity decrease systematically with increasing strain, indicating faster energy dissipation and altered defect recombination behavior under applied stress. Analysis of the dislocation structure shows that Shockley-type partial dislocations dominate the microstructural response, while Hirth and other dislocation types remain comparatively minor. Both the total and Shockley dislocation densities reach a saturation value of $~10^{16}m^{-2}$ , marking the establishment of a steady-state microstructure governed by the balance between dislocation accumulation and recovery. The evolution of the total dislocation density with strain is successfully described by the Kocks-Mecking model, demonstrating its applicability to strain-dependent irradiation effects in metallic systems

Shirui Zhou, Shiteng Zheng, Junfang Tian et al.

The Intelligent Driver Model (IDM), proposed in 2000, has become a foundational tool in traffic flow modeling, renowned for its simplicity, computational efficiency, and ability to capture diverse traffic dynamics. Over the past 25 years, IDM has significantly advanced car-following theory and found extensive application in intelligent transportation systems, including driver assistance systems and autonomous vehicle control. However, IDM's deterministic framework and simplified assumptions face limitations in addressing real-world complexities such as stochastic variability, driver heterogeneity, and mixed traffic conditions. This paper provides a systematic review and critical reflection on IDM's theoretical foundations, academic influence, practical applications, and model extensions. While highlighting IDM's contributions, we emphasize the need to extend the model into a modular and extensible framework. Future directions include integrating stochastic elements, human behavioral insights, and hybrid modeling approaches that combine physics-based structures with data-driven methodologies. By reimagining IDM as a flexible modeling basis, this paper aims to inspire its continued development to meet the demands of intelligent, connected, and increasingly complex traffic systems.

Hathaipat Leetrakool, Thanathorn Wonglerttham, Sornchaya Sonthyanonth et al.

Objectives: This study aimed to evaluate medical students' attitudes towards abortion and their confidence in providing abortion services in the future. Material and methods: A national cross-sectional online survey was conducted among fifth and sixth-year medical students from 10 Thai universities. A self-administered questionnaire assessed their knowledge, attitudes, and confidence regarding abortion services. Of 340 questionnaires sent, 234 responses were received. We used descriptive statistics and multivariable analysis to explore agreement with abortion and confidence. Results: The mean attitude score towards abortion was 72.68 ± 7.46 out of 85, with 75.6 % of students indicated a favorable attitude toward abortion. The most widely accepted reasons for abortion were serious congenital anomalies in the fetus (99.6 %) and pregnancy resulting from sexual crimes (98.7 %). However, only 42.8 % of the students were willing to provide abortion services, and 33.8 % felt confident in doing so. Additionally, 77.8 % believed that participating in abortion procedures during medical school would increase their confidence in providing these services. No factors were found to be significantly associated with agreement on abortion. Conclusion: Although most medical students had a positive attitude towards abortion, only a minority expressed willingness and confidence in providing abortion care. These findings underscore the importance of incorporating hands-on experience in abortion procedures in medical school curricula.

Neeta Singh, Ankita Sethi, Lata Rani et al.

Background: While trophectoderm (TE) biopsy with next-generation sequencing (NGS) remains the gold standard for preimplantation genetic testing for aneuploidy (PGT-A), the discovery of cell-free DNA (cfDNA) in spent culture media (SCM) has sparked interest in non-invasive PGT-A (NiPGT-A) as a potential alternative. Aim: The study was conducted to assess the feasibility of cell cfDNA from SCM as a tool for NiPGT-A in patients undergoing IVF for advanced age, repeated implantation failure or severe male factor infertility. Settings and Design: This is a prospective study where a total of 44 embryos having TE biopsy for aneuploidy testing and their respective SCM collected at day 5/6 were analysed. Materials and Methods: All aneuploid blastocysts (WB) were subjected to DNA extraction and amplification using Sureplex DNA amplification system followed by library preparation using VeriSeq™ PGS Library Prep kit and sequencing on MiSeq (Illumina, California, USA). Statistical Analysis Used: Copy Number Variation visualisation and analysis were carried out using BlueFuse Multi Software (Illumina). The statistical data were analysed by STATA version 14. Results: Informative results were obtained in 36/44 (81.2%) SCM samples. The reads were analysable in 26 paired (SCM and TE biopsy) samples. Concordant NGS results for both TE biopsy and SCM sample were obtained in 17/26 (65.38%) embryos. The per chromosome concordance rate was 85.13% (487/572) and the sex chromosome concordance rate was 73% (19/26). The sensitivity and specificity of NiPGT-A were 66.6% and 60%, respectively. On comparing the ploidy concordance rate, poor morphology embryos had better, but not statistically significant concordance rate (83.33%) as compared to good morphology embryos (50%, P = 0.16). Although not significant, day 6 embryos had better per chromosome as well as sex chromosome concordance rate as compared to day 5 embryos. Conclusion: Aneuploidy testing using cf DNA in SCM is a promising technique but needs more research on larger cohort size to improve the sensitivity, specificity and concordance rate.

Thomas G. Kelly, Mohammad D. Soorati, Klaus-Peter Zauner et al.

Swarm robotics is a study of simple robots that exhibit complex behaviour only by interacting locally with other robots and their environment. The control in swarm robotics is mainly distributed whereas centralised control is widely used in other fields of robotics. Centralised and decentralised control strategies both pose a unique set of benefits and drawbacks for the control of multi-robot systems. While decentralised systems are more scalable and resilient, they are less efficient compared to the centralised systems and they lead to excessive data transmissions to the human operators causing cognitive overload. We examine the trade-offs of each of these approaches in a human-swarm system to perform an environmental monitoring task and propose a flexible hybrid approach, which combines elements of hierarchical and decentralised systems. We find that a flexible hybrid system can outperform a centralised system (in our environmental monitoring task by 19.2%) while reducing the number of messages sent to a human operator (here by 23.1%). We conclude that establishing centralisation for a system is not always optimal for performance and that utilising aspects of centralised and decentralised systems can keep the swarm from hindering its performance.

Cuc Thi Kim Mai, Janne Halme, Heikki A. Nurmi et al.

Despite attractive cost-effectiveness, scalability, and superior stability, carbon-based printable perovskite solar cells (CPSCs) still face moisture-induced degradation that limits their lifespan and commercial potential. Here, we investigate the moisture-preventing mechanisms of thin nanostructured super-repellent coating (advancing contact angle $>$167$^{\circ}$ and contact angle hysteresis 7$^{\circ}$ integrated into CPSCs for different moisture forms (falling water droplets vs water vapor vs condensed water droplets). We show that unencapsulated super-repellent CPSCs have superior performance under continuous droplet impact for 12h (rain simulation experiments) compared to unencapsulated pristine (uncoated) CPSCs that degrade within seconds. Contrary to falling water droplets, where super-repellent coating serves as a shield, we found water vapor to physisorb through porous super-repellent coating (room temperature and relative humidity, RH 65\% and 85\%) that increased the CPSCs performance for 21\% during ~43 days similarly to pristine CPSCs. We further showed that, water condensation forms within or below the super-repellent coating (40$^{\circ}$ C and RH 85\%), followed by chemisorption and degradation of CPSCs. Because different forms of water have distinct effect on CPSC, we suggest that future standard tests for repellent CPSCs should include rain simulation and condensation tests. Our findings will thus inspire the development of super-repellent coatings for moisture prevention.

Aditya Pillai, Gabriel Ponte, Marcia Fampa et al.

In optimal experimental design, the objective is to select a limited set of experiments that maximizes information about unknown model parameters based on factor levels. This work addresses the generalized D-optimal design problem, allowing for nonlinear relationships in factor levels. We develop scalable algorithms suitable for cases where the number of candidate experiments grows exponentially with the factor dimension, focusing on both first- and second-order models under design constraints. Particularly, our approach integrates convex relaxation with pricing-based local search techniques, which can provide upper bounds and performance guarantees. Unlike traditional local search methods, such as the ``Fedorov exchange" and its variants, our method effectively accommodates arbitrary side constraints in the design space. Furthermore, it yields both a feasible solution and an upper bound on the optimal value derived from the convex relaxation. Numerical results highlight the efficiency and scalability of our algorithms, demonstrating superior performance compared to the state-of-the-art commercial software, JMP

Freweini Martha Tesfai, Jasleen Nagi, Iona Morrison et al.

Abstract Introduction There is a growing emphasis on proficiency‐based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity. Material and methods A systematic search (1989–2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single‐group (with pre‐ and post‐training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta‐analysis. Results A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure‐specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes. Conclusions Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.

Ahmed Ali Hassan, Abdullah Al-Nafeesah, Ishag Adam et al.

Objectives There is an increasing trend of pre-diabetes and diabetes mellitus (DM) among adolescents, and sub-Saharan Africa is no exception. However, few published data on pre-diabetes among adolescents in Sudan exist. We aimed to investigate the prevalence of and factors associated with pre-diabetes among adolescents in Eastern Sudan.Design A community-based cross-sectional study was conducted from August to October 2023.Settings This community-based study was conducted in Gadarif city, the capital of Gadarif state, Eastern Sudan.Participants Adolescents (within the ages of 10–19 years).Main outcome measures A questionnaire was used to collect socio-demographic information. Anthropometric and glycated haemoglobin (HbA1c) measurements were performed in accordance with standard procedures. Multivariate logistic regression analysis was performed.Results Of the 387 enrolled adolescents, 207 (53.5%) were female and 180 (46.5%) were male. The median (IQR) age was 14.0 (12.0–16.0) years. 39.5% of the participants’ fathers were employed. The median (IQR) HbA1c was 5.5% (5.2%–5.8%). One-third (32.6%) of the adolescents had pre-diabetes or DM. Of the participants, 67.4%, 30.0% and 2.6% had no DM, pre-diabetes or type 2 DM, respectively. In the univariate analysis, the father’s employment (OR=1.60, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes; age, sex, parents’ education, the mother’s occupation, body mass index z-score, cigarette smoking and a family history of DM were not associated with pre-diabetes. In the multivariate analysis, the father’s employment (adjusted OR=1.70, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes.Conclusion Pre-diabetes is a significant public health problem among adolescents in Eastern Sudan. The introduction of early screening programmes for pre-diabetes at the community level is recommended to halt the progression of pre-diabetes to DM and to deal with existing DM among adolescents.

Jiaying Tao, Zhixian Shi, Mulan Li et al.

Growing teratoma syndrome (GTS) is a rare condition that arises secondary to malignant germ cell tumors. It is characterized by an enlarging abdominal mass during or after chemotherapy, normal tumor markers, and histopathological indications of mature teratoma components. Awareness of GTS is limited, and it is often mistaken for disease progression or recurrence. This misdiagnosis can lead to delayed treatment and increased risk of complications. Therefore, early identification of GTS is crucial to avoid unnecessary systemic treatments and reduce financial burden. GTS is unresponsive to chemotherapy or radiotherapy and complete surgical resection is the sole therapeutic strategy. In this report, we present a case of GTS in a 20-year-old female following treatment for immature teratoma, alongside a review of the relevant literature aimed at enriching our insight into the clinical manifestations of GTS.

Zhiguo Ding, Robert Schober, Bayan Sharif et al.

An effective way to realize non-orthogonal multiple access (NOMA) assisted grant-free transmission is to first create multiple receive signal-to-noise ratio (SNR) levels and then serve multiple grant-free users by employing these SNR levels as bandwidth resources. These SNR levels need to be pre-configured prior to the grant-free transmission and have great impact on the performance of grant-free networks. The aim of this letter is to illustrate different designs for configuring the SNR levels and investigate their impact on the performance of grant-free transmission, where age-of-information is used as the performance metric. The presented analytical and simulation results demonstrate the performance gain achieved by NOMA over orthogonal multiple access, and also reveal the relative merits of the considered designs for pre-configured SNR levels.

Shweta Agrawal, Sagnik Saha, Nikolaj I. Schwartzbach et al.

In the average-case $k$-SUM problem, given $r$ integers chosen uniformly at random from $\{0,\dots,M-1\}$, the objective is to find a ``solution'' set of $k$ numbers that sum to $0$ modulo $M$. In the dense regime of $M \leq r^k$, where solutions exist with high probability, the complexity of these problems is well understood. Much less is known in the sparse regime of $M\gg r^k$, where solutions are unlikely to exist. In this work, we initiate the study of the sparse regime for $k$-SUM and its variant $k$-XOR, especially their planted versions, where a random solution is planted in a randomly generated instance and has to be recovered. We provide evidence for the hardness of these problems and suggest new applications to cryptography. Complexity. First we study the complexity of these problems in the sparse regime and show: - Conditional Lower Bounds. Assuming established conjectures about the hardness of average-case (non-planted) $k$-SUM/$k$-XOR when $M = r^k$, we provide non-trivial lower bounds on the running time of algorithms for planted $k$-SUM when $r^k\leq M\leq r^{2k}$. - Hardness Amplification. We show that for any $M \geq r^k$, if an algorithm running in time $T$ solves planted $k$-SUM/$k$-XOR with success probability $Ω(1/\text{polylog}(r))$, then there is an algorithm running in time $\tilde{O}(T)$ that solves it with probability $(1-o(1))$. - New Reductions and Algorithms. We provide reductions for $k$-SUM/$k$-XOR from search to decision, as well as worst-case and average-case reductions to the Subset Sum problem from $k$-SUM, as well as a new algorithm for average-case $k$-XOR at low densities. Cryptography. We show that by additionally assuming mild hardness of $k$-XOR, we can construct Public Key Encryption (PKE) from a weaker variant of the Learning Parity with Noise (LPN) problem than was known before.

Maggie Kirkman, Amy Dobson, Karalyn McDonald et al.

Abstract Background Female genital cosmetic surgery (FGCS) changes the structure and appearance of healthy external genitalia. We aimed to identify discourses that help explain and rationalise FGCS and to derive from them possibilities for informing clinical education. Methods We interviewed 16 health professionals and 5 non-health professionals who deal with women’s bodies using a study-specific semi-structured interview guide. We analysed transcripts using a three-step iterative process: identifying themes relevant to indications for FGCS, identifying the discourses within which they were positioned, and categorising and theorising discourses. Results We identified discourses that we categorised within four themes: Diversity and the Normal Vulva (diversity was both acknowledged and rejected); Indications for FGCS (Functional, Psychological, Appearance); Ethical Perspectives; and Reasons Women Seek FGCS (Pubic Depilation, Media Representation, Pornography, Advertising Regulations, Social Pressure, Genital Unfamiliarity). Conclusions Vulvar aesthetics constitute a social construct to which medical practice and opinion contribute and by which they are influenced; education and reform need to occur on all fronts. Resources that not only establish genital diversity but also challenge limited vulvar aesthetics could be developed in consultation with women, healthcare practitioners, mental health specialists, and others with knowledge of social constructs of women’s bodies.

Qing Chen, Xiaowei Zhang, Qicai Hu et al.

Abstract Background Chronic endometritis (CE) is a disease of continuous and subtle inflammation occurring in the endometrial stromal area, which is often asymptomatic or present with non-specific clinical symptoms. Methods This study investigated the composition and distribution of the intrauterine microbiota of 71 patients who underwent hysteroscopy during the routine clinical inspection of infertility. Among them, patients who were diagnosed with chronic endometritis (CE) were allocated into CE group (n = 29) and others into non-CE group (n = 42). There was no significant difference in average age between the two groups (P = 0.19). Uterine flushing fluid was collected by the self-developed cervical trocar uterine cavity sampler and 16S rRNA sequencing was performed. Results The alpha diversity in the CE group was significantly higher than that in the non-CE group (P < 0.05). Firmicutes (newly named Bacillota) were the dominant phylum in the non-CE group (72.23%), while their abundance was much lower in the CE group (49.92%), but there was no statistically significant difference between the two groups. The abundances of Actinobacteriota and Cyanobacteria in the CE group were significantly higher than those in the non-CE group (P < 0.05). At the genus level, the abundance of Lactobacillus dominated in all samples, which presented a significantly lower abundance in the CE group (40.88%) than that in the non-CE group (64.22%) (P < 0.05). Correspondingly, the abundance of non-Lactobacillus was higher in the CE group, among which Pseudomonas and Cutibacterium increased significantly (P < 0.01). Moreover, compared with the non-CE group, the pathways involved in arginine and proline metabolism and retinol metabolism were significantly enriched in the CE group (P < 0.05), while the metabolism of lipid and prenyltransferases were significantly decreased in the CE group (P < 0.05). Conclusions A certain microbial community was colonized in the uterine cavity, which was dominated by Lactobacillus. The structure and distribution of intrauterine microbiota in the CE group were different from those in the non-CE group by showing a lower abundance of Lactobacillus, and a significantly higher abundance of Pseudomonas and Cutibacterium. Additionally, the microbial metabolism was altered in the CE group. This study elaborated the alteration of intrauterine microbiota in CE patients, which may contribute to the diagnosis of CE and provide a reference for antibiotic treatment of CE.

Jan Hansen, Jannik Nedergaard Pedersen, Jan Skov Pedersen et al.

Intermolecular interactions in protein solutions in general contain many contributions. If short-range attractions dominate, the state diagram exhibits liquid-liquid phase separation (LLPS) that is metastable with respect to crystallization. In this case, the extended law of corresponding states (ELCS) suggests that thermodynamic properties are insensitive to details of the underlying interaction potential. Using lysozyme solutions, we investigate the applicability of the ELCS to the static structure factor and in how far effective colloidal interaction models can help to rationalize the phase behavior and interactions of protein solutions in the vicinity of the LLPS binodal. The (effective) structure factor has been determined by small-angle X-ray scattering (SAXS). It can be described by Baxter's adhesive hard-sphere model, which implies a single fit parameter from which the normalized second virial coefficient $b_2$ is inferred and found to quantitatively agree with previous results from static light scattering. The $b_2$ values are independent of protein concentration, but systematically vary with temperature and solution composition, i.e. salt and additive content. If plotted as a function of temperature normalized by the critical temperature, the values of $b_2$ follow a universal behaviour. These findings validate the applicability of the ELCS to globular protein solutions and indicate that the ELCS can also be reflected in the structure factor.

Kenusha Devi Tiwari, Ganesh Dangal, Aruna Karki et al.

Background: Hysterectomy is one of the most common operations performed by the gynecologists second to caesarean section. Hysterectomies are done vaginally, laparoscopically or abdominally. This study has been conducted to compare the complications of abdominal hysterectomy with non-descent vaginal hysterectomy with an aim to establish a safer, superior and lesser complication for the patients. Methods: This is a cross sectional study conducted at Kathmandu Model Hospital over the period of one year among 70 women. Women according to inclusion criteria were randomly allocated into two groups; 35 women in group 1 underwent non-descent vaginal hysterectomy and 35 in group 2 underwent total abdominal hysterectomy. Demographic data, intraoperative blood loss, intraoperative complications, operation time, postoperative complications, pain, and hospital stay was recorded and analyzed using statistical tool..  Results: The average age of the women was 45.77±6.33 years. Median blood loss (p=0.033) and hospital stay (p=0.005) was significantly low in group 1 as compare to group 2. Mean pain score at discharge (p=0.0005) and follow-up (p=0.0005) was also significantly less in group 1 as compared to group 2. Overall rate of complication was rare and not statistically significant between groups (p=0.643). Rate of wound infection was 5.7% that was observed in group 2, Vault infection 5.7% in group 1, UTI in 2 cases (5.7%) and paralytic ileus was found in 1 case in group 2. Conclusions: Non-descent vaginal hysterectomy is safe, effective and feasible procedure compared with abdominal hysterectomy. Less complications, faster operating time and easy recovery post operatively makes this a patient friendly mode of hysterectomy. Keywords: Hysterectomy; non-descent vaginal hysterectomy; vault infection; wound infection

Shizuka Sakurai, Ryoko Asano, Megumi Furugori et al.

Objective: To report the rare case of gestational primary ovarian choriocarcinoma coexistent with intrauterine pregnancy, successfully treated with surgery and systemic chemotherapy. We also describe the utility of short tandem repeat (STR) genotyping in the diagnosis of choriocarcinoma. Case report: A 38-year-old woman at 17 gestational weeks presented with an ovarian tumor rupture in the left ovary. Left salpingo-oophorectomy was performed and the patient was diagnosed with gestational ovarian choriocarcinoma via histopathology and STR genotyping. After artificial abortion, the patient underwent 8 cycles of chemotherapy. Abdominal hysterectomy was performed because of the presence of low levels of human chorionic gonadotropin and the tumor that developed behind the uterus. However, no viable choriocarcinoma cells were found in the residual tumor, suggesting that the patient achieved full remission. Conclusions: Early detection is crucial in treating choriocarcinomas; thus, clinicians should consider the possibility of choriocarcinoma at the presence of an ovarian tumor during pregnancy. Gestational and non-gestational choriocarcinomas differ in prognosis and sensitivity to chemotherapy due to their different etiologies. Therefore, STR genotyping may be beneficial in predicting the patient's prognosis or selecting the appropriate regimen.

Chao Li, Hongdou Li, Xiaoying Yao et al.