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Whether surgical treatment of tubal pregnancy affects the outcomes of concomitant live normally sited (eutopic) pregnancies is unknown. The purpose of this study was to investigate the outcomes of live eutopic singleton pregnancies following surgical treatment for concomitant fallopian pregnancies. A total of 446 patients who conceived tubal heterotopic pregnancies (HPs) via in vitro fertilization–embryo transfer and underwent surgical treatment to remove ectopic pregnancies (EPs) were included. For each study patient, one matched patient who conceived a live eutopic singleton pregnancy was selected randomly as a control. The rates of early miscarriage, late miscarriage, live birth, preterm birth, low birth weight and perinatal mortality were not significantly different between the study and control groups. The birth weight were also similar between these two groups. However, the caesarean section rate was significantly higher in the study group than that in the control group(P < 0.001). Additionally, laparotomy and laparoscopy for tubal HPs yielded similar pregnancy outcomes. Compared with controls, patients who conceived tubal pregnancies and concomitant live eutopic singleton pregnancies had similar pregnancy outcomes after proper surgical treatment of EPs. These findings can be used for counselling women who have conceived tubal HPs regarding the risks associated with surgical treatment. [ABSTRACT FROM AUTHOR]

Objective: To clarify whether intrauterine adhesions (IUAs) affect endometrial receptivity (ER) on the day of ovulation and to compare patients with mild and moderate-severe adhesions. Methods: This prospective cohort study included 592 infertile women with IUAs who underwent frozen-thawed embryo transfer (FET). Patients were divided into groups with or without IUAs; and pregnant and nonpregnant populations based on whether a clinical pregnancy was achieved. The ultrasound ER parameters on the ovulation day were compared. Patients with IUAs were then divided into mild or moderate-severe IUA subgroups according to IUA degree. Results: The proportions of patients with Type B plus Type C endometrial morphology (94% vs. 75%, P<0.001), an endometrial thickness≥8mm (97% vs. 81%, P<0.001), an endometrial volume≥2ml (94% vs. 67%, P<0.001), a frequency of endometrial peristalsis≥2 times/min (84% vs. 53%, P<0.001), low subendometrial volume (11.54 ± 2.94 vs. 9.57 ± 2.35, P<0.001) and subendometrial vascularization flow index (VFI) values (2.70 ± 3.10 vs. 2.23 ± 2.23, P=0.033) and a low live birth rate (65% vs. 56%, P=0.039) were significantly higher in the group without IUAs than in the group with IUAs. The group with moderate-severe IUAs had lower proportion of patients with an endometrial thickness≥8mm (73% vs. 89%, P=0.008) and an endometrial volume ≥2ml (58% vs. 78%, P=0.005), a lower frequency of endometrial peristalsis≥2 times/min (42% vs. 65%, P=0.003), and low subendometrial volume (9.22 ± 2.29 vs. 9.97 ± 2.36, P=0.023) and subendometrial flow index (FI) (31.48 ± 3.64 vs. 33.43 ± 4.17, P=0.002) values than the group with mild IUAs; a high antral follicle count (AFC), basal follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH) levels and an endometrial thickness≥8mm were independent predictors of clinical pregnancy. Conclusion: IUAs can affect ER on the ovulation day and the live birth rate during natural cycles. Moderate-severe IUAs have a greater impact on ER than mild adhesions do; however, if these adhesions are treated properly, they do not have adverse effects on the clinical pregnancy rate. A high AFC, basal FSH and AMH levels and an endometrial thickness ≥8 mm were found to be independent predictors of clinical pregnancy. [ABSTRACT FROM AUTHOR]

Objectives: The coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life‐threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology. Methods: This retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high‐risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes. Results: Among the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full‐term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%). Conclusions: Though the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP. [ABSTRACT FROM AUTHOR]

The rapid growth of the dye industry and the worsening water resource crisis have drawn significant focus to the treatment of dye wastewater. Membrane separation technology is increasingly being utilized in addressing this issue. However, traditional separation membranes face challenges such as susceptibility to contamination and significant decline in subsequent separation permeance. This work utilizes a straightforward brushing technique to effectively apply a coating comprising titanium dioxide (TiO2) nanoparticles and attapulgite (APT) onto a stainless steel mesh (SSM), equipping it with the capability for dye adsorption and separation. Studies show that coatings with different ratios yield varying degrees of coverage on the SSM. A higher concentration of TiO2/attapulgite results in improved coverage on the SSM, creating a denser coating on the mesh surface and the degree of cross-linking of the coating was as high as 92.22%. The coated meshes exhibited superhydrophilicity uniformly and excellent negatively charged properties. Separation experiments of the meshes with different TiO2/attapulgite ratios were conducted by separating simulated dye wastewater with methylene blue (MB) and safranine T (SaT). The results indicate that the prepared meshes achieved a maximum rejection of over 98.0% for MB and over 96.5% for SaT. In addition, the prepared meshes maintained high dye rejection efficiencies (>96%) even after 10 consecutive separation cycles. The above results indicate that the prepared meshes are promising for application in industrial dye wastewater treatment. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the ultrasound characteristics, clinical management, and pregnancy outcomes of heterotopic intramural pregnancies (HIMPs) after embryo transfer., Methods: This was a retrospective observational study of women who were diagnosed with HIMPs. The ultrasound characteristics, clinical treatment, and pregnancy outcomes of patients with HIMPs were evaluated., Results: Eight women with HIMPs were included. Among them, 6 patients were diagnosed by transvaginal sonography, and 2 patients were misdiagnosed with heterotopic interstitial pregnancy. The diagnostic accuracy was 75% (6/8). Five patients with HIMPs were diagnosed at the time of the initial scan (5+6-6+3 weeks). An intramural gestational sac was observed in all 6 patients, and an embryo with cardiac activity was detected in one patient on the follow-up scans. Intrauterine pregnancies (IUPs) were revealed in all 6 patients, and embryo(s) with cardiac activity were observed in 5 patients at the time of the initial diagnosis or later. The patients receiving expectant treatment all presented with bagel signs, while patients with embryos with cardiac activity all underwent surgery. Among the 6 diagnosed women, 1 patient was initially treated medically, 4 were treated expectantly, and 1 was treated surgically. Among the 6 diagnosed patients, the IUPs of 5 patients resulted in live infants., Conclusion: Single ET should be recommended to decrease the possibility of HIMP. An accurate diagnosis of HIMP was reached in most cases by detailed ultrasound early in the first trimester. Most IUPs of HIMPs seem to have good outcomes with timely and proper management. Expectant management might be a possible choice for nonviable intramural pregnancies., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: Cesarean scar pregnancy (CSP) is one of the rarest ectopic pregnancies which may be associated with life-threatening complications. Owing to the rarity of CSP, little is known about it. This study aimed to evaluate the value of the first-trimester transvaginal sonography (TVS) diagnosis and the risk factors of CSP after in vitro fertilization-embryo transfer (IVF-ET)., Methods: This was a retrospective study of women undergoing IVF-ET between January 2013 and December 2018. Women who were diagnosed with a CSP using TVS and confirmed by surgery and histological examination were included. The clinical data and ultrasound findings were collected and analyzed. Univariate and multivariate logistic regression analyses were performed for evaluation of possible influence factors. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TVS were calculated for the diagnosis of CSP., Results: Overall, 75,438 consecutive women who underwent IVF-ET had received TVS during this period. Of these, 4,817 women (6.4%) had a history of cesarean section and 83 cases were found to have a CSP. Due to the absence of histological data, 19 cases treated conservatively were excluded. Finally, 64 cases were included, among whom 63 cases were correctly diagnosed [including 17 cases of heterotopic CSP (HCSP)] and 1 case was missed using TVS. Another 1 case of inevitable miscarriage was misdiagnosed as a CSP. The maternal age at the initial scan [34.0 (range, 26.0-44.0) years], the infertility duration [4.0 (range, 1-12) years], and the initial diagnostic time after ET [27 (range, 20-50) days] were recorded. A gestational sac (GS) was observed in all 63 cases during ultrasound examinations, including 28 with fetal pole, 25 with a yolk sac only, and 10 with an empty sac. The sensitivity and specificity of first-trimester TVS in diagnosing CSP were 98.44% and 99.98%, respectively; the PPV and NPV were 98.44% and 99.98%, respectively. Multivariate logistic regression analysis showed thinner endometrial thickness (ET) on transfer day [adjusted odds ratio (aOR): 0.83; 95% confidence interval (CI): 0.76-0.93, P<0.001] and multiple ET (aOR 53.60, 95% CI: 5.31-1,736.00, P=0.008) were independent risk factors for CSP and HCSP, respectively., Conclusions: First-trimester TVS performed by an experienced sonographer has a high sensitivity for making the correct diagnosis of CSP after IVF-ET, which is helpful for clinical intervention and avoiding severe complications. For patients with a history of cesarean section, thinner ET on the transfer day and bigger body mass index (BMI) seem to be risk factors for CSP; single blastocyst transfer should be recommended to decrease the possibility of HCSP. The clinical significance of this study still needs to be considered., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1239/coif). All authors report the funding from the Research Grant of CITIC-Xiangya (Nos. YNXM-202220 and YNXM-202310) and Hunan Provincial Grant for Innovative Province Construction (No. 2019SK4012). The authors have no other conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)