Aim: During pregnancy, the ovarian endometrioma generally decreases in size and occasionally ruptures. We evaluated (1) whether and how ovarian-endometrioma size changes from the first trimester to the postdelivery period, and (2) the type of endometrioma more likely to rupture during pregnancy. Methods: During an 18-year period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018), ultrasound in the first trimester revealed ovarian endometrioma in 149 pregnant women at our tertiary institute. Among these, we subjected 138 endometriomas in 145 patients to expectant management (wait-and-watch approach during pregnancy). We compared the cyst sizes in the first trimester and the postdelivery period, and defined a >1 cm diameter size-change as a significant increase/decrease. We analyzed four patients with rupture and characterized the predictors of rupture. Results: A comparison of cyst sizes in the first trimester and the postdelivery period revealed that the size of 94 (68%), 37 (27%), and 7 ovaries (5.0%), respectively, decreased, remained unchanged, and increased; in 56 ovaries (40%), apparent cysts were no longer present. Of the 145 patients, four (2.8%) required emergency surgery for cyst rupture. Adhesion to the surroundings, an increase in cyst size, large size (diameter of ≥6 cm), and compression due to the enlarged uterus in late pregnancy were factors clinically related to rupture.Conclusions: Approximately two-thirds of ovarian endometriomas decreased in size during pregnancy (40% disappeared), 27% remained unchanged, and only 5% increased in size. However, 2.8% of pregnant women with endometrial cysts experienced rupture. We characterized risk factors for rupture; however, clinical application requires further evaluation.

Laparoscopic uterosacral ligament suspension vs laparoscopic sacral colpopexy in patients with pelvic organ prolapse: intermediate term follow-up of a retrospective study

No abstract

To clarify the clinical experiences of newly qualified midwives who participated in clinical practice as midwives for one year after they had completed basic training. Methods Focus group interviews were conducted with five midwives who participated in clinical practice for one year after they had completed their basic training. A qualitative and inductive approach was used to explore the clinical experiences through their oral responses. Results As for results with the research, it was clarified that the newly qualified midwives have seven categories of impressions as given below; "They are satisfied with environment to acquire the experience as midwives." "They feel that the work of midwives is worthwhile and fulfilling." "They cannot be involved in the care for pregnant and parturient woman in satisfied way with more care." "They are frustrated about the gap between their knowledge which they learned with basic midwifery training and clinical practice." "They are frustrated because there is any friend sharing their experience." "They are anxious about the gap between their ability and required ability in practice" "They want to keep working as midwives." Discussion To form a career of midwives, consideration for the amount of conduct of labor which they experienced and its review, mental and educational support of senior for the newly qualified midwives with considering their individuality and continuous education to make up for the gap between the basic education and the clinical practice are highly needed.