Naturally occurring heterotopic pregnancy with a monoamniotic monochorionic twin gestational pregnancy: a case report.

Background: We describe a case of a heterotopic pregnancy that included a rare spontaneous twin gestational monoamniotic monochorionic pregnancy in a patient with a history of questionable contraceptive practices and a previous left salpingectomy secondary to a ruptured ectopic pregnancy.

Case: A 34-year-old woman, gravida 2, para 1001, at 9 weeks + 2 days' gestational age by her last menstrual period on etonogestrel vaginal ring contraception presented with progressively increasing right lower quadrant abdominal pain, increasing abdominal girth, and vaginal bleeding. Transvaginal ultrasound revealed an intrauterine pregnancy along with a ruptured right tubal pregnancy.

A warm-up laparoscopic exercise improves the subsequent laparoscopic performance of Ob-Gyn residents: a low-cost laparoscopic trainer.

Introduction: Residents traditionally acquire surgical skills through on-the-job training. Minimally invasive laparoscopic techniques present additional demands to master complex surgical procedures in a remote 2-dimensional venue. We examined the effectiveness of a brief warm-up laparoscopic simulation toward improving operative proficiency.

Placement of a Word catheter: a resident training model.

Objective: The present study developed and evaluated a practical teaching model and training protocol for Word catheter placement in the treatment of a Bartholin gland cyst.

Study Design: Residents were asked to treat a model of the female perineum, fashioned from harvested porcine tissue, with a simulated Bartholin cyst via Word catheter placement and drainage. Each resident was evaluated for procedural competence.

Sexual response in the patient after hysterectomy: total abdominal versus supracervical versus vaginal procedure.

Objective: The present study examines the patient's own appraisal of her sexual responsiveness after hysterectomy.

Study Design: Four hundred women who had undergone hysterectomy within a 3-year period were selected randomly and asked to respond to a questionnaire that was devised to ascertain the patient's own objective evaluation of self-image, sexuality, and sexual response before and after hysterectomy. The confidential responses were analyzed, noting the presence of any significant divergence between demographic and procedural cohorts.

Obstetric predictors of placental/umbilical cord blood volume for transplantation.

Objective: Umbilical cord blood is an effective alternative to bone marrow as a source of hematopoietic stem cells in transplantation. However, the amount of donor blood and the cell content that are collected may be insufficient for engraftment in some adult recipients. This study identifies obstetric factors that affect retrievable placental cord blood volume.

Recent progress in minimally invasive conduit harvesting.

Wound-related morbidity frequently encountered after open-incision harvesting of vessel conduits for coronary artery bypass grafting (CABG) is invariably recognized as an obstacle impeding the patient's path towards complete postoperative recovery. The endoscopic approach provides surgical access to the intended conduit vessel while affording an appreciably lower incidence of traumatic injury to the surrounding tissues. For this reason, the minimally invasive endoscopic dissection of vessel conduits is steadily gaining acceptance as a preferable alternative to the standard open-incision technique.