Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.

Objective: To investigate the clinical features of hyperemesis gravidarum in Eastern Asian women. Method: Retrospective cohort study was conducted based on delivery records. Hyperemesis gravidarum was defined as a pregnancy with severe nausea and vomiting necessitating hospitalization with a body weight loss of over 5% from pre-pregnancy weight with ketonuria. The onset is at 10 weeks of gestation or less. Maternal and neonatal variables were compared. Result: There were 3,350 singleton deliveries in the study period. All subjects were Eastern Asian women. Hyperemesis gravidarum was observed in 119 cases (3.6%). Hyperemesis gravidarum subjects had a smaller pre-pregnancy body weight (50.5 ± 0.64 kg vs. 51.8 ± 0.16 kg, p = 0.046) and a smaller pre-pregnancy body mass index compared to non-hyperemetic subjects (20.2 ± 0.21 kg/m² vs. 20.8 ± 0.06 kg/m², p = 0.02). Conclusion: The Eastern Asian population had a significantly higher incidence of hyperemesis gravidarum. Small pre-pregnancy body habitus increased the risk of hyperemesis gravidarum.

ObjectiveThe Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system.MethodsData of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model.ResultsIn total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR= 0.598; p=0.003).ConclusionIt was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.

The titration of salivary cortisol concentrations and chromogranin A/protein levels is a useful tool to determine maternal stress levels. The elevation of cortisol and chromogranin A/protein in the saliva was suppressed in the chronic high stress group during pregnancy.

More women prefer the left lateral position during the second half of pregnancy. More fetuses are in the left occiput in utero during the late stage of pregnancy. However, no statistical relationship was observed between maternal and fetal positioning.