The aim of this study is to compare the clinical outcomes and to identify risk factors for emergent cesarean delivery and planned cesarean delivery in patients with placenta accreta spectrum (PAS) disorders in Vietnam. The medical records of patients admitted to our hospital with a diagnosis of PAS disorders >5 years were retrospectively reviewed. A total of 255 patients with PAS disorders were identified, including 95 cases in the emergent delivery group and 160 cases in the planned delivery group. The percentage of complete/partial placenta previa in the planned delivery group was significantly higher than that in the emergent delivery group (59.22% vs 32.16%, P = .027). Fewer patients in the planned group had vaginal bleeding compared with those in the emergent group (29 vs 36 cases, P < .001). The percentage of blood transfusion was similar between the 2 groups; however, the transfused units of pack red blood cells were greater in the emergent delivery group (5.3 ± 0.33 vs 4.5 ± 0.25 U, P = .036). When considering the neonatal outcomes, the data demonstrated that the planned delivery group had a significantly higher birth weight and a lower rate of preterm delivery than the emergent group ( P < .001). The mean gestational age at delivery for the emergent group was 35.1 ± 0.27 weeks compared with 38.0 ± 0.10 weeks for the planned group ( P < .001). The increased risk factors for emergent delivery were vaginal bleeding (odds ratio 2.86, 95% confidence interval 1.59–5.26) and preterm delivery (odds ratio 5.26, 95% confidence interval 2.13–14.29). Planned delivery is strongly associated with a lower need for blood transfusion and better neonatal outcomes compared with emergent delivery. Antenatal vaginal bleeding and preterm labor are risk factors for emergent delivery among patients with PAS disorders. Based on the results of this study, we recommend that the management strategies for patients with PAS disorders should be individualized to determine the optimal timing of delivery and to decrease the rate of emergent cesarean delivery.

Rationale: Abdominal ectopic pregnancy is a very rare form of ectopic pregnancy, yet is associated with higher morbidity due to atypical clinical presentation and misdiagnosis. In this report, we present a case of abdominal ectopic pregnancy with placenta invading to the rectal wall. Patient concerns: A 32-year-old woman was admitted to our hospital with an increasing serum ß-hCG level after diagnostic laparoscopy for ectopic pregnancy in the provincial hospital. During the laparoscopy, no gestational sac was found. She was discharged and scheduled for a follow-up visit to assess the level of ß-hCG. One week later, her serum ß-hCG level increased from 7000 IU/l to 12000 IU/l. Transvaginal Doppler ultrasound and abdominal computed tomography (CT) angiography demonstrated a right adnexal mass adherent to the rectal wall. Diagnosis: A rectal ectopic pregnancy is suspected. Interventions: Laparoscopic surgery was successfully performed in our hospital to remove the products of conception. Outcomes: Histologic examination confirmed the diagnosis of a rectal ectopic pregnancy. The patient had an uneventful recovery and was discharged the next few days. Lessons: This case report reveals that an abdominal pregnancy is remarkably difficult to diagnose and manage. The gynecologists need to be aware of the possibility of gestational sac between the uterus and the rectum. To make early diagnosis of abdominal pregnancy, they need to combine clinical findings, imaging techniques (ultrasound, CT, MRI) and serial human chorionic gonadotropin measurements. Laparoscopic management should be considered in early abdominal pregnancy. A multidisciplinary team of gynecologists and gastrointestinal surgeons is required to deal with rectal ectopic pregnancy.

No abstract

To validate the Vietnamese version Internet Gaming Disorder-20 (VN-IGD-20) Test for teenagers, a survey among 349 gamers, who were accepted in the interview, from secondary and high schools from 28 game stores was conducted in Hanoi, Vietnam. The IGD-20 Test comprised 20 items with six different dimensions, using a 5-point Likert scale. Exploratory factor analysis (EFA) and confrmatory factor analysis (CFA) were used to examine the validation; Cronbach’s Alpha was performed to test the reliability; and Latent class analysis (LCA) was applied to identify the level of internet gaming disorder (IGD). Moreover, the ROC curve diagram was used with the highest Youden’s Index parameter to determine the best cut-off point. CFA proved that the VN-IGD-Test with 17 items, which was divided into fve-factor dimensions. The model indexes of the Vietnamese questionnaire included RMSEA = 0.053; SRMR = 0.052; GFI = 0.929; TLI = 0.908 and CFI = 0.927. The values for Cronbach’s alpha coeffcient of each dimension ranged from 0.823 to 0.840. The LCA found out four levels of IGD: casual gamers, regular gamers, low-risk engaged gamers, and high-risk engaged gamers. Additionally, the optimal empirical cut-off point with the highest Youden’s Index was 47.5 (out of 85). The present study fndings illustrated that the VN-IGD-17 Test could be used as a valid and reliable tool for assessing internet gaming disorder in Vietnamese teenagers.