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Objective: To show the impact of Sjögren's syndrome (SS) on maternal and fetal outcomes following pregnancy. Methods: We performed a literature search based on PubMed, Web of science, Wan fang, China National Knowledge Infrastructure and ProQuest databases from 1 January 2007 to 6 November 2022. Grading of Recommendations, Assessment, Development, and Evaluations approach was used to assess the certainty of the evidence. Systematic reviews and meta-analyses were performed using RevMan 5.3 software. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. Trial sequential analyses were performed by TSA 0.9. Results: Nine studies with 2341 patients and 2472 pregnancies with SS were included in our analysis. This current analysis showed pregnancy hypertension and preeclampsia/eclampsia to be significantly higher in pregnant women with SS compared to pregnant women without SS (OR: 1.65, 95% CI: 1.04–2.63; P = 0.03), (OR: 2.06, 95% CI: 1.16–3.65; P = 0.01) respectively. Cesarean section, thromboembolic disease, premature rupture of membranes, and spontaneous abortion were also significantly higher in the SS women with OR: 2.07, 95% CI: 1.48–2.88; P < 0.0001, OR: 9.45, 95% CI: 1.99–44.87; P = 0.005, OR: 1.36, 95% CI: 1.13–1.64; P = 0.001, OR: 9.30, 95% CI: 4.13–20.93; P < 0.00001, respectively. Significantly higher premature births were observed with infants who were born from SS mothers (OR: 2.19, 95% CI: 1.54–3.12; P < 0.0001). Infants defined as 'small for gestational age/intrauterine growth restriction' and 'weighing < 2500 g' were also significantly higher in patients suffering from SS (OR: 2.26, 95% CI: 1.38–3.70; P = 0.001), (OR: 3.84, 95% CI: 1.39–10.61; P = 0.009) respectively. In addition, live birth significantly favored infants who were born from mothers without SS (OR: 21.53, 95% CI: 8.36–55.44; P < 0.00001). Subgroup analysis by sample size revealed that pregnancy hypertension risk has significantly increased in small cohort (OR: 2.74, 95%CI: 1.45–5.18), and a slight increase was found in population-based studies (OR: 1.14, 95%CI: 0.91–1.43). In both small cohorts and population-based researches, cesarean section was significantly higher in SS (OR: 2.13, 95% CI: 1.29, 3.52; OR: 1.85, 95% CI: 1.29–2.64, respectively). The number of infants with intrauterine growth restriction did not grow in the population-based researches (OR: 2.07, 95%CI: 0.92–4.66) although there has been an increase in small reports (OR: 2.53, 95%CI: 1.16–5.51). Subgroup analysis was conducted on the basis of study location (not Asian vs. Asian countries) indicated that cesarean section was significantly higher in SS in both countries (OR: 1.69, 95% CI: 1.31–2.18; OR: 3.37, 95% CI: 2.39–4.77, respectively). Conclusion: This meta-analysis has shown SS to have a high impact on maternal and fetal outcomes following pregnancy. [ABSTRACT FROM AUTHOR]

This article discusses a case study of a 58-year-old woman who underwent minimally invasive surgery to remove migrated intrauterine devices (IUDs). The woman had an IUD inserted 25 years ago, and imaging tests revealed that the IUDs had migrated to different locations within her pelvic cavity. The surgery was successful in removing both IUDs. The article also provides information on the use of IUDs, the complications associated with them, and the recommended intervention for removing migrated IUDs. The study was conducted by Ying Jin, Tenglan Wu, Jianmei Liao, Ying Liu, and Xiaoqin Gan, and it was supported by funding from Chengdu Science and Technology Bureau and Chengdu Municipal Health Commission. [Extracted from the article]

Purpose: To assess the safety and efficacy of local intra-gestational sac methotrexate injection followed by dilation and curettage (D&C) in treating cesarean scar pregnancies (CSP).Method: Medical records of CSP patients treated with local intra-gestational sac methotrexate injection followed by dilation and curettage were analyzed at the Maternal and Child Hospital of Guangxi Zhuang Autonomous Region, China.Results: Thirty-one patients were included in this study. The mean gestational age, sac diameter and thickness of the uterine scar were 49.6 ± 7.7 days, 1.8 ± 0.6 cm and 0.30 ± 0.15 cm, respectively. The median pretreatment serum β-human chorionic gonadotropin (β-HCG) level was 40,887 mIU/mL, with the 25th and 75th percentiles at 19,852 and 74,552, respectively. The median blood loss during D&C was 20 mL with the 25th and 75th percentiles at 10 mL and 50 mL. Following D&C, a Foley's balloon catheter compression was implanted in 26 (83.9%) patients due to active uterine bleeding. All patients had a β-HCG regression time of ≤ 4 weeks after D&C. While 30 patients (96.8%) had a uterine recovery time of ≤ 4 weeks, and 29 patients (93.5%) had resumption of menstruation of less than 6 weeks. Three patients (9.7%) had complications. One of them suffered from massive vaginal bleeding and underwent s blood transfusion. There were no other complications, such as pelvic infection and uterine rupture during the procedures. And no patient was converted to surgical resection or uterine artery embolization. Overall, 30 patients (96.8%) were treated successfully.Conclusion: Local intra-gestational sac methotrexate injection followed by D&C with the aid of a Foley's balloon catheter compression appears to be a safe and effective treatment for CSP. Further randomized controlled trials are suggested to confirm these findings. [ABSTRACT FROM AUTHOR]