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Introduction: Ovarian artery aneurysm is a rare diagnosis, primarily associated with late pregnancy and the postpartum period. It can cause life-threatening hemorrhage when ruptured. Even more rare are ovarian artery aneurysms in postmenopausal women.Case Report: We present a case of a postmenopausal female presenting to the emergency department with flank pain. Point-of-care ultrasound showed free fluid in the abdomen. She was diagnosed with an ovarian artery aneurysm on computed tomography angiography and treated successfully with embolization.Conclusion: Ruptured ovarian artery aneurysm is an uncommon cause of intra-abdominal hemorrhage in women.

Uterine leiomyomas are one of the most common smooth muscle tumors in women. Cervical leiomyomas, in contrast, are a relatively rare entity with limited available information, presenting a challenge for determining optimal treatment. Uterine artery embolization of cervical leiomyomas has been previously explored and met with some success. However, it has been associated with complications such as expulsion or incomplete embolization. This case, however, describes a patient who presented with a large cervical fibroid and was successfully treated with bilateral ovarian artery embolization, resulting in decreased fibroid burden and resolution of the patient's symptoms. Previous reports have demonstrated successful ovarian artery embolization for uterine leiomyomas, but this approach has yet to be shown for a cervical leiomyoma. Given the challenge presented by cervical leiomyomas, this case emphasizes a unique anatomical variant and the embolization method, providing an alternative, less-invasive option for reducing patient disease burden.

Summary: Background: Premature ovarian failure (POF) is a prevalent and severe condition that impairs female health but there is currently no effective treatment available to restore ovarian function. Human amniotic epithelial cells (hAECs) exhibit ovarian protection in pre-clinical models. Thus, we conducted a single-arm, phase 1 clinical trial to assess the safety and efficacy of allogenic hAECs in treating POF. Methods: A total of 35 patients received 6 × 107 hAECs via ovarian artery and completed a five-month follow-up from December 30, 2020 to January 31, 2022. The follow-up assessments were conducted at various intervals after hAECs treatment, including one month (Visit-1, V-1), three months (Visit-2, V-2), and five months (Visit-3, V-3) post-treatment. The primary endpoints were incidence of adverse events (AEs), and clinically significant laboratory abnormalities. Secondary endpoints included evaluation of transvaginal ultrasound results, sex hormone levels, Menopausal Quality of Life (MENQOL) questionnaire, as well as reproductive indicators. This trial was registered at www.clinicaltrials.gov as NCT02912104. Findings: No serious AEs were observed throughout the five-month follow-up period. The most common AE was hematoma (7/35, 20.00%), and other AEs include pelvic pain (4/35, 11.43%), fever (2/35, 5.71%), anaphylaxis (2/35, 5.71%), and hepatotoxicity (1/35, 2.86%). After hAECs transplantation (hAECT), significant improvements were observed in the levels of endometrial thickness, left ovarian volume, sex hormones (follicle-stimulating hormone (FSH) and estradiol (E2)), and MENQOL scores in all patients during the five-month follow-up period. Among them, 13 participants (37.14%) experienced spontaneous menstrual bleeding, and 20.00% (7/35) reported more than one regular menstrual bleeding post-hAECT. In this response group, significant improvements were observed in endometrial thickness, left ovarian volume, levels of FSH, E2, anti-Müllerian hormone (AMH), and MENQOL scores one month after hAECT in comparison to pre-hAECT. Interpretation: hAECT via ovarian artery is safe, well-tolerated and temporarily ameliorates endometrial thickness, ovarian size, hormone levels, and menopausal symptoms in POF patients. Further randomized controlled trial of hAECs with longer follow-up period and a larger sample size is warranted. Funding: National Natural Science Foundation of China (No. 82271664), the Interdisciplinary Program of Shanghai Jiao Tong University (YG2022ZD028), the Shanghai Municipal Health Committee (202240345), Shanghai Key Laboratory of Embryo Original Diseases (No. Shelab2022ZD01), Shanghai Municipal Education Commission (No. 20152236), and National Key Research and Development Program of China (No. 2018YFC1004802), Shanghai Clinical Research Center for Cell Therapy, China (No. 23J41900100).

This report addresses three variants identified within a female cadaver. Specifically, these were an anomalous origin of the right suprarenal artery, an abnormal bilateral ovarian vein branch, and a arterial tortuosity of the left ovarian artery. Indeed, the cadaver evinced abnormal origins in the case of the middle suprarenal artery (MSA), right inferior phrenic artery (IPA), and the renal capsule artery (emanating from the right renal artery). The MSA and IPA shared a common trunk with the inferior suprarenal artery. It was additionally observed that the right ovarian vein anastomoses the branches from the right kidney posterior inferior along with those to the renal fat capsule. Abnormal origin was evident in the case of the left ovarian artery, and arterial tortuosity was apparent in the lower region of the vessels. This report addresses both the clinical import of these variations and their likely causes. In the subdiaphragmatic region, surgical success and prognosis may be impacted by such anomalies; accordingly surgeons must be aware of anatomical variants of the ovarian and suprarenal arteries. [ABSTRACT FROM AUTHOR]

Abstract To investigate the ovarian responses, ovarian and uterine hemodynamics, circulating ovarian hormones, and nitric oxide (NO) with their relations in superstimulated cows. Eight Holstein Friesian dry cows previously synchronized with CIDR underwent rectal Doppler ultrasound scanning and blood sampling after administrating eCG (1500 I.U) on day 10 of the second ovulation (day -5). Cows were treated with 12.5 mg prostaglandin F2α (PGF2α) on days 10 and 17 after ovulation. Estradiol, progesterone, and NO were measured. Results showed that from ≥ 13 follicles, five follicles ovulated from both ovaries. The ovulated follicles increased antrum colored area and colored area % till day -1. The developed corpora lutea (CLs) attained similar diameter, area, colored area, and colored area % from day 2 till day 15. The peak point of velocity (PSV) of uterine arteries decreased while that of ovarian arteries increased from day -4 to day 0. Both ovarian arteries diameter, resistance index (RI), PSV, end velocity (EDV) and systolic/diastolic ratio (S/D) positively correlated (P

To investigate the ovarian responses, ovarian and uterine hemodynamics, circulating ovarian hormones, and nitric oxide (NO) with their relations in superstimulated cows. Eight Holstein Friesian dry cows previously synchronized with CIDR underwent rectal Doppler ultrasound scanning and blood sampling after administrating eCG (1500 I.U) on day 10 of the second ovulation (day -5). Cows were treated with 12.5 mg prostaglandin F2α (PGF2α) on days 10 and 17 after ovulation. Estradiol, progesterone, and NO were measured. Results showed that from ≥ 13 follicles, five follicles ovulated from both ovaries. The ovulated follicles increased antrum colored area and colored area % till day -1. The developed corpora lutea (CLs) attained similar diameter, area, colored area, and colored area % from day 2 till day 15. The peak point of velocity (PSV) of uterine arteries decreased while that of ovarian arteries increased from day -4 to day 0. Both ovarian arteries diameter, resistance index (RI), PSV, end velocity (EDV) and systolic/diastolic ratio (S/D) positively correlated (P < 0.0001), but their pulsatility index (PI) negatively correlated (P < 0.0001). The uterine arteries PI, RI, PSV, EDV, time average velocity (TAMV) and S/D negatively correlated (P < 0.0001) but their diameters positively correlated. Estradiol increased but progesterone decreased from day -5 till day 0. After ovulation, P4 reached maximum values on day 9 and started to decrease till day 19.NO showed one peak on day -3 and another one from day 3 to day 9. Conclusions: Blood flow of ovarian arteries is different from uterine arteries and depended on pre- or post-ovulation. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this study is to assess the prevalence of unstable ovarian artery doppler indices in patients with polycystic ovarian syndrome. Methodology: This is cross-sectional descriptive study, conducted at a tertiary care hospital from February 2021 to January 2022. A total of 130 patients with polycystic ovarian syndrome. The patients included were those having duration of illness was more than 3 months, age between 20-40 years. Patients with influencing factors e.g., high prolactin and hypothyroidism were excluded from the study. The selected patients were undergone transabdominal ultrasound for the localization of anatomical position of ovarian arteries. Pulsed doppler range gate was established across the vessel and mean of three waveforms was observed. The doppler artery indices included were pulsatility index (PI) and resistive index (RI). The values were obtained and recorded. Results: The mean age of patients was 29.33 ± 4.11 years. Majority of patients (54.33%) were between the 19-29 years. Mean time of duration of polycystic ovarian syndrome (PCOS) was 3.11 ± 1.43 years. Mean body mass index (BMI) was 28.38 ± 2.01 kg/m². The frequency of deranged arterial involvement in patients was 71%. Conclusion: The findings suggested that the prevalent of deranged ovarian artery indices (RI and PI) in polycystic ovarian syndrome (PCOS) is significantly high. [ABSTRACT FROM AUTHOR]

The objective was to study the ovarian dynamics and ovarian arterial blood flow by pulse-wave color Doppler ultrasonography during estrus in Purnathadi buffaloes. The mean ovarian diameter of left and right ovary was 2.27±0.08 and 2.37 ± 0.12 cm of right ovary and mean pre-ovulatory follicle diameter was 1.23±0.08 cm during estrus Purnathadi buffaloes. The mean ovarian pulsatility index and resistance index was 1.45 and 0.75 during estrus. The mean ipsilateral (on the side of pre-ovulatory follicle) and contralateral ovarian artery pulsatility index during estrus did not differ significantly (1.63±0.02 and 1.62±0.02, respectively). The mean ipsilateral (on the side of pre-ovulatory follicle) and contralateral ovarian artery resistance index during estrus did not differ significantly (0.77±0.01 and 0.75±0.01, respectively). The ovarian artery indices show non-significant levels irrespective of presence of pre-ovulatory follicle in Purnathadi buffalo. [ABSTRACT FROM AUTHOR]

Abstract. One of the main complications during early embryogenesis and placentation is placental insufficiency. Under the influence of various factors, namely infectious factors, which, depending on the biological specificity, negatively affect the germ cells of the parents, the development of the embryo, the formation of the trophoblast and the placenta, which in turn leads to a violation of the function of the placental complex and gestational complications during pregnancy. Due to the expansion of diagnostic possibilities for detecting placental function disorders, as well as in connection with the emergence of new data on the mechanisms of blood circulation regulation in the placenta to assess the functional state of the feto-placental complex at the stage of the formation of primary placental insufficiency against the background of inflammatory diseases of the female genital organs, we were determined the dopplerometric pattern of blood flow (ovarian artery, intervillous space) in women of the main and control groups. Goal. To determine the dopplerometric pattern of blood flow characteristics (ovarian artery, chorionic volume, blood flow study in different areas of the chorion) in pregnant women against the background of inflammatory diseases of the female genital organs in the early trimester of pregnancy. Materials and methods. The main group consisted of 37 women with signs of inflammatory diseases of the female genital organs, the control group consisted of 30 practically healthy women. The results. Obtaining new data on the mechanisms of blood circulation regulation in the ovarian artery and intervillous space at the stage of formation of the placental complex in physiological and complicated pregnancy will allow to supplement the question of the pathogenesis of the development and prevention of placental insufficiency. Conclusions. The study of the blood flow of extraembryonic structures in the early stages of gestation allows to diagnose structural changes at the stage of placenta formation. Violation of blood flow in the first trimester of pregnancy against the background of an infectious factor that penetrates into various vascular links of the mother-placenta-fetus system with the deduction of blood flow volume indicators demonstrates the regularity of the formation of disturbed hemodynamics at the stage of formation of the placental complex. These indicators can serve as a criterion for the selection of women of the risk group for the formation of primary placental insufficiency.

Abstract Understanding the does reproductive hemodynamic changes during the estrous cycle is crucial for improving reproductive competence and fertility potential in this species. The objective of this study is to investigate the hemodynamic variations in ovarian (OA) and uterine (UA) arteries, histological and morphometric changes in ovarian and uterine tissues throughout the follicular (FP) and luteal (LP) phases in rabbits and determine estrogen (ER), progesterone (PR) receptors, and vascular endothelial growth factor (VEGF) distributions using immunohistochemistry. Fourteen adults pluriparous New Zealand rabbits were divided into rabbits at the FP (Day − 1; n = 7) and those at the LP (Day 9; n = 7). Animals were subjected to Doppler, hormonal (estrogen [E2], progesterone [P4], insulin-like growth factor [ILGF], and VEGF), histological, and immunohistochemical analyses. In LP, OA Doppler indices were significantly increased, whereas peak systolic velocity (PSV) was decreased compared with that in FP. UA Doppler indices were significantly decreased in the LP, whereas PSV was increased (P

It is well known that the blood supply of the greater omentum and female internal genital organs are not physiologically connected. There is also no mention of such anatomical variation in anatomical, radiological, or surgical textbooks. Here we present a very rare case report of atypical double arterial anastomosis (the first and second variant artery) between the right limb of the omental arcade of Barkow, uterus, and right ovary, which was found during a routine student anatomical dissection course. It is very challenging to find a proper explanation for the presence of the described anatomical variation; however, we hypothesized that it is based on their common embryonic origin - the mesentery. The first and second variant arteries could be remnants of transient anastomoses or collateral circulation, which were present during embryonic development and persisted until adulthood. Moreover, during our literature review, we noticed that the general description of omental blood supply and its possible variations is relatively poor; therefore, we emphasize the need for more precise knowledge regarding these anatomical parts, which could help surgeons who are performing abdominal or pelvic surgeries in preventing avoidable bleeding. [ABSTRACT FROM AUTHOR]

Uterine leiomyomas are one of the most common smooth muscle tumors in women. Cervical leiomyomas, in contrast, are a relatively rare entity with limited available information, presenting a challenge for determining optimal treatment. Uterine artery embolization of cervical leiomyomas has been previously explored and met with some success. However, it has been associated with complications such as expulsion or incomplete embolization. This case, however, describes a patient who presented with a large cervical fibroid and was successfully treated with bilateral ovarian artery embolization, resulting in decreased fibroid burden and resolution of the patient's symptoms. Previous reports have demonstrated successful ovarian artery embolization for uterine leiomyomas, but this approach has yet to be shown for a cervical leiomyoma. Given the challenge presented by cervical leiomyomas, this case emphasizes a unique anatomical variant and the embolization method, providing an alternative, less-invasive option for reducing patient disease burden., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Understanding the does reproductive hemodynamic changes during the estrous cycle is crucial for improving reproductive competence and fertility potential in this species. The objective of this study is to investigate the hemodynamic variations in ovarian (OA) and uterine (UA) arteries, histological and morphometric changes in ovarian and uterine tissues throughout the follicular (FP) and luteal (LP) phases in rabbits and determine estrogen (ER), progesterone (PR) receptors, and vascular endothelial growth factor (VEGF) distributions using immunohistochemistry. Fourteen adults pluriparous New Zealand rabbits were divided into rabbits at the FP (Day − 1; n = 7) and those at the LP (Day 9; n = 7). Animals were subjected to Doppler, hormonal (estrogen [E2], progesterone [P4], insulin-like growth factor [ILGF], and VEGF), histological, and immunohistochemical analyses. In LP, OA Doppler indices were significantly increased, whereas peak systolic velocity (PSV) was decreased compared with that in FP. UA Doppler indices were significantly decreased in the LP, whereas PSV was increased (P < 0.05). E2 levels were increased in the FP, whereas P4 levels were increased in the LP. The morphometric analysis of uterine tissues during the LP revealed an increase in the mean uterine endometrium length, endometrial connective tissue area percentage (%), endometrial glands number, myometrial area (%) and thickness. Furthermore, ovarian follicles and corpus luteum (CL) displayed strong positive immunoreactivity for ER, PR, and VEGF-A during both phases. The ovarian sections displayed a substantial (P < 0.05) increase in the area % of VEGF-A in the ovarian follicles during FP while in the CL during LP. Conversely, area percentage of VEGF-A immunoreactivity in the uterine luminal and glandular epithelia during the FP and LP revealed no differences. However, the number of VEGF-A–stained blood capillaries revealed an increase during LP than FP. In conclusion, this study demonstrated for the first time the changes in both ovarian and uterine arteries during two different phases of the rabbit cycle in relation to the histo-morphometric analysis and distribution of ER, PR, and VEGF-A, which regulate uterine functions that play a role in reproduction. [ABSTRACT FROM AUTHOR]

We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the performance of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) at 1.5 T and 3 T for the visualization of uterine and ovarian arteries (OAs) before uterine artery embolization (UAE).Methods: Preprocedural pelvic NCE-MRA images of 85 symptomatic patients undergoing UAE for the treatment of uterine leiomyomas were reviewed by two specialists in pelvic MRI. Left and right uterine arteries (UAs) were judged separately and scored on a 5-point scale. Score 5 was the highest, in which the UA could be visualized inside the musculature, forming a peritumoral plexus. Score 1 was the lowest, where visualization was limited to the descending segment. The detection of enlarged OAs was also compared. The Mann-Whitney U and Fisher exact tests were used for statistical analysis. p < 0.05 was considered to be statistically significant.Results: Of the 170 UAs, 110 were classified at 1.5 T and 60 were classified at 3 T. Median (interquartile range [IQR]) score was 3 (IQR: 2-4) for visualization at 1.5 T vs 5 (IQR: 4-5) for 3 T. The scores for UA visualization were significantly higher at 3 T (p < 0.05). For enlarged OAs, NCE-MRA at 1.5 T and 3 T visualized 7 and 5 enlarged OAs, respectively; there was no significant difference between the two field strengths (p = 0.36).Conclusions: NCE-MRA performed at 3 T can visualize UAs over a greater range than at 1.5 T. No difference was found regarding the detection of enlarged OAs.Key Points: • Preprocedural MRA can provide interventional radiologists with valuable information, including the origin and course of the uterine arteries and the existence of collateral feeders to the tumor. • This study demonstrates the superiority of non-contrast-enhanced MRA performed at 3 T over that performed at 1.5 T in the visualization of the uterine arteries in patients undergoing uterine artery embolization for the treatment of uterine leiomyomas. • Non-contrast-enhanced MRA is a useful imaging modality for patients with symptomatic leiomyoma undergoing uterine artery embolization in whom contrast administration is unfeasible. If available, it is preferable to perform the examination with a 3 T MR unit rather than a 1.5 T MR unit. [ABSTRACT FROM AUTHOR]

Objective: To assess blood flow parameters as well as Doppler indices at the first six months of pregnancy in buffalo heifers. Methods: A total of 15 healthy, cycling, buffalo heifers were examined twice per month. Examination of Doppler ultrasonography started from the first month till the sixth months of pregnancy. All animals were subjected to transrectal Doppler ultrasonography to assess ovarian and uterine blood flow. Resistance index, pulsatility index, peak systolic velocity, end diastolic velocity, and blood flow rate were measured of both ipsilateral and contralateral to the fetus side. Results: The resistance index was positively correlated with the pulsatility index (r=0.62, P

Background: Premature ovarian failure (POF) is a prevalent and severe condition that impairs female health but there is currently no effective treatment available to restore ovarian function. Human amniotic epithelial cells (hAECs) exhibit ovarian protection in pre-clinical models. Thus, we conducted a single-arm, phase 1 clinical trial to assess the safety and efficacy of allogenic hAECs in treating POF., Methods: A total of 35 patients received 6 × 10 7 hAECs via ovarian artery and completed a five-month follow-up from December 30, 2020 to January 31, 2022. The follow-up assessments were conducted at various intervals after hAECs treatment, including one month (Visit-1, V-1), three months (Visit-2, V-2), and five months (Visit-3, V-3) post-treatment. The primary endpoints were incidence of adverse events (AEs), and clinically significant laboratory abnormalities. Secondary endpoints included evaluation of transvaginal ultrasound results, sex hormone levels, Menopausal Quality of Life (MENQOL) questionnaire, as well as reproductive indicators. This trial was registered at www.clinicaltrials.gov as NCT02912104., Findings: No serious AEs were observed throughout the five-month follow-up period. The most common AE was hematoma (7/35, 20.00%), and other AEs include pelvic pain (4/35, 11.43%), fever (2/35, 5.71%), anaphylaxis (2/35, 5.71%), and hepatotoxicity (1/35, 2.86%). After hAECs transplantation (hAECT), significant improvements were observed in the levels of endometrial thickness, left ovarian volume, sex hormones (follicle-stimulating hormone (FSH) and estradiol (E2)), and MENQOL scores in all patients during the five-month follow-up period. Among them, 13 participants (37.14%) experienced spontaneous menstrual bleeding, and 20.00% (7/35) reported more than one regular menstrual bleeding post-hAECT. In this response group, significant improvements were observed in endometrial thickness, left ovarian volume, levels of FSH, E2, anti-Müllerian hormone (AMH), and MENQOL scores one month after hAECT in comparison to pre-hAECT., Interpretation: hAECT via ovarian artery is safe, well-tolerated and temporarily ameliorates endometrial thickness, ovarian size, hormone levels, and menopausal symptoms in POF patients. Further randomized controlled trial of hAECs with longer follow-up period and a larger sample size is warranted., Funding: National Natural Science Foundation of China (No. 82271664), the Interdisciplinary Program of Shanghai Jiao Tong University (YG2022ZD028), the Shanghai Municipal Health Committee (202240345), Shanghai Key Laboratory of Embryo Original Diseases (No. Shelab2022ZD01), Shanghai Municipal Education Commission (No. 20152236), and National Key Research and Development Program of China (No. 2018YFC1004802), Shanghai Clinical Research Center for Cell Therapy, China (No. 23J41900100)., Competing Interests: All authors have no conflict of interest to declare., (© 2024 The Author(s).)

This study determined the ovarian, uterine, and luteal hemodynamic variations using Doppler between pregnant and non-pregnant pluriparous buffalos in relation to their anatomical and histological basics during the first 31 days after natural mating. Adult healthy cyclic Egyptian buffalo (n = 10) were selected and categorized into two groups; group 1 (n = 5) was mated naturally by a fertile bull during the late estrus phase, and group 2 (n = 5) was not mated. Animals were subjected to Doppler ultrasonography to evaluate luteal, ovarian, and uterine blood flows from day 7 until day 31 post-mating. Besides, three pregnant (one month) and other non-pregnant uterus (n = 6) were obtained from a local abattoir to study the anatomical and histological features. Our results revealed that the luteal, ovarian, and uterine arteries cross-sectional diameters/mm increased (P < 0.05) from day 7 till day 31. Resistance (RI) and pulsatility indices (PI) decreased linearly (P < 0.05) in pregnant buffalos till day 31, but the peak systolic, end diastolic velocities and flow volume of those arteries were increased. Additionally, luteal colored areas away and toward CL were increased (P < 0.05) in the pregnant group compared to non-pregnant ones. There was a significant (P < 0.05) increase in the lumen diameter of luteal, ovarian, and uterine artery sections in pregnant buffalos compared to those of non-pregnant ones. While the mean value of tunica media's thickness of both luteal and uterine artery was significantly higher in non-pregnant buffalos than pregnant ones, except for that of the ovarian artery. Additionally, the ovarian and uterine artery tunica muscularis relative area % was (P < 0.05) higher in pregnant buffalos than in non-pregnant ones, except for that of the luteal artery. It was concluded that in pregnant buffalos, ovarian, uterine, and luteal blood flows were improved from the first week until 31 days post-mating via a decline in both Doppler indices with an increase in Doppler velocities and blood flow volume in relation to their histological changes based on their anatomical architecture in comparison to non-pregnant one. • The decline in Doppler indices indicates a higher vascularization to luteal tissue. • Tunica muscularis relative area % was higher in pregnant buffalos. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of ovarian arteries on the use of prophylactic abdominal aortic balloon occlusion (PABO) in patients with coexisting placenta accreta and placenta previa. Methods: Thirty-two pregnant women with coexisting placenta accreta and placenta previa treated with PABO in our hospital during 2013–2020 were retrospectively analyzed. The patients were divided into two groups: one with infra-renal abdominal aortic balloon occlusion above the ovarian artery (Group A, n = 15) and the other with occlusion below the ovarian artery (Group B, n = 17). Medical records and relevant imaging of all patients were reviewed. All Cesarean deliveries were scheduled and we decided to perform hysterectomy based on the surgical findings. Results: Patients in both groups were similar in terms of age, gravidity history, and status of placenta. Regarding their outcomes, estimated blood loss was not significantly different in both groups, although it was lower in Group B than in Group A (3949.5 vs. 4333.8 ml). The other tested parameters did not show any difference. The uterus was preserved in 13 (41%) patients. No access-related or balloon occlusion-related complications occurred in either group. Conclusions: PABO was safe. However, the balloon location (above or below the ovarian arteries) did not influence the outcomes. Further evaluation and prospective studies are required to evaluate the safety and efficacy of balloon occlusion above or below the ovarian artery in patients with coexisting placenta accreta and placenta previa.

Purpose This prospective cross‐sectional study aimed to compare uterine and ovarian arterial Doppler signals in regularly menstruating patients who had been using copper intrauterine devices (IUD) for different durations. Methods: Four groups of participants were formed (n = 30 for each) depending on the duration of copper IUD use: less than 1 year (group 1), 1 to 3 years (group 2), and over 3 years (group 3). Women without IUDs formed the control group. All participants were called in on the fifth‐eighth days of their menstrual cycle for Doppler blood flow assessment. The pulsatility index (PI) and resistance index (RI) values were recorded in uterine and ovarian arteries. Results: The groups 2 and 3 had significantly higher uterine artery PI and RI values than groups 1 and 4. Furthermore, group 2 had uterine and ovarian artery PI and RI values similar to those of group 3. There was a positive relationship between uterine and ovarian arteries' PI and RI values with the duration of IUD use. Conclusions: The presence of an IUD for over a year seems to cause changes in the uterine artery PI and RI values assessed by Doppler ultrasonography. [ABSTRACT FROM AUTHOR]

Aim: In this prospective cross-sectional study, we compared the uterine and ovarian artery blood flow parameters in patients diagnosed with unexplained primary infertility with fertile cases. Materials and Methods: Thirty female patients previously diagnosed as unexplained primary infertility aged 20-40 years were selected. The control group consisted of 30 fertile patients. To evaluate uterus and ovaries, all participants underwent ultrasonographic examination on the third day of the mestrual cycle. Also, blood samples were taken to evaluate the basal hormonal profile. Participants were re-evaluated on the 21st day of the menstrual cycle. Blood samples were taken for the measurement of progesterone level. Maximum endometrial thickness in the sagittal plane on both sides of the endometrial line was measured using transvaginal ultrasonography. Also, blood flows in uterine and ovarian arteries were measured via transvaginal Doppler ultrasonography. Resistance index and pulsatility index values in both uterine and ovarian arteries were recorded and averaged. Results: Both groups had similar clinical features and endometrial thickness values (P > 0.05). Patients with unexplained primary infertility had similar uterine and ovarian blood flow parameters compared to fertile patients (P > 0.05). There was no correlation between uterine and ovarian Doppler findings and demographic-clinical data. Conclusion: Patients with unexplained primary infertility have similar uterine and ovarian blood flow values compared with fertile patients. [ABSTRACT FROM AUTHOR]

To compare the prevalence of enlarged ovarian and intrapelvic parasitic arteries to the gravid uterus between cases of placenta accreta spectrum (PAS) and those with normal placentation using unenhanced magnetic resonance (MR) angiography. Unenhanced time-of-flight MR angiography was performed in 12 consecutive women with PAS (mean age, 34 years; range, 23–42 years) and 24 women with normal placentation (mean age, 31 years; range, 24–42 years) in their third trimester and reviewed by two independent observers. The consensus reading served as the reference standard. Findings of pelvic arteriography performed at cesarean hysterectomy were reviewed in all cases of PAS. The prevalence of enlarged ovarian and intrapelvic parasitic arteries was compared using Fisher's exact test. The interobserver agreement was assessed with Kappa statistics. The prevalence of enlarged ovarian arteries was not significantly different between cases of PAS and normal placentation (17% [4/24 pelvic sides] vs. 4% [2/48 pelvic sides], P =.091). The prevalence of intrapelvic parasitic arteries was significantly higher in cases of PAS than in those with normal placentation (67% [16/24 pelvic sides] vs. 0% [0/48 pelvic sides], P <.0001). On a patient-by-patient basis, the intrapelvic parasitic artery was frequently present in women with PAS (92% [11/12 patients]). The Kappa values were 0.915 and 0.852 for detecting enlarged ovarian and intrapelvic parasitic arteries, respectively, indicating excellent interobserver agreement. The development of intrapelvic parasitic arteries was an anomalous phenomenon observed on unenhanced MR angiography in the majority of women with PAS but was not observed in those with normal placentation. • MR angiography showed enlarged ovarian and intrapelvic parasitic arteries to the gravid uterus. • Enlarged ovarian arteries were rarely seen with or without placenta accreta spectrum. • Intrapelvic parasitic arteries were seen in the majority of cases with placenta accreta spectrum. • Intrapelvic parasitic arteries were not observed in cases with normal placentation. [ABSTRACT FROM AUTHOR]

To investigate the ovarian and uterine blood flow responses, hemodynamic, circulating ovarian hormones and nitric oxide (NO) after end of treatment by Folltropin. Holstein Friesian (12) cows previously synchronized with CIDR underwent Doppler ultrasound after administrating of FSH daily for 4 days in eight injections started on day 10 of the second ovulation (day −5). Oestradiol (E2), progesterone (P4) and nitric oxide (NOMs) were measured. During the follicular phase, follicle area and antrum area of the second cycle reached maximum value on the day of ovulation compared with that in the first cycle, while during the luteal phase, both showed a pattern of increase and decrease. The luteal area and total coloured area increased till day 10 in the first and second cycle. The first cycle ipsilateral ovarian artery (Ov.A) had higher pulsatility (PI) (p =.001), resistance (RI) (p =.001), peak velocity (PSV) (p =.009) and lower end‐diastolic velocity (EDV) (p =.003) compared with the second cycle. The increased ipsilateral Ov.A PSV (p =.009) was accompanied by lower EDV. The first cycle ipsilateral middle uterine artery (MUA) had higher PI (p =.001) and RI (p =.001), with lower PSV (p =.001) and EDV (p =.001). It was concluded that blood flow of ovarian and middle uterine arteries changed after the end of superstimulation as the increased ipsilateral Ov. A and MUA PSVs accompanied by lower EDV and both Doppler indices that reflect the amount of ovarian and uterine blood flow waveform. [ABSTRACT FROM AUTHOR]

A 41‐year‐old woman (gravida 2, para 1) underwent elective termination of pregnancy at approximately 7 weeks of gestation. At 1 month after the elective abortion, she was referred due to abnormal results in a cervical cytological examination. Transvaginal ultrasonography showed a heterogeneous mass of 16 mm in diameter in the left adnexal region. At 3 months after her referral, the asymptomatic left adnexal mass had increased to 55 mm in diameter. Prominent vascular flow was detected in the solid portion by color Doppler ultrasonography. Magnetic resonance imaging showed suspected hemorrhage in the left adnexal cystic mass. Three‐dimensional computerized tomographic angiography showed the prominent development of tortuous blood vessels in the left adnexal region, which originated from the left ovarian artery. The patient had a negative β‐human chorionic gonadotropin (hCG) level. Left salpingectomy was performed by a single‐port laparoscopic approach. A pathological examination revealed degenerated villous tissue with β‐hCG‐positive syncytiotrophoblasts. [ABSTRACT FROM AUTHOR]

Contents: The aim was to compare the early luteal development in ewes superovulated with different doses of pFSH. Twenty‐nine Santa Inês ewes received a progesterone device (CIDR®) for 8 days. Gonadotrophic treatment started on Day 6: G200 (control, n = 9, 200 mg); G133 (n = 10, 133 mg); and G100 (n = 10, 100 mg of pFSH). On Day 6, all females received eCG (300 IU). B‐mode and spectral Doppler ultrasonography were performed daily during the early luteal phase (Days 11–15) to monitor the development of corpora lutea (CLs; dimensions) and ovarian arteries indices. CLs were also classified as normal or prematurely regressed (PRCL) on Day 15 by videolaparoscopy. Ewes from G100 and G133 showed gradual increase in luteal diameter during the early luteal phase (p < 0.001), whereas G200 animals presented increase from Day 11 to Day 13, and then decrease on Days 14 and 15 (p < 0.001). The G200 females showed greater percentage of PRCL (45.20%) than those of the other groups (p < 0.001). The normal CLs number was greater in G100 than in G133 (p = 0.04), while the PRCL number was greater in G200 than in the other groups (p = 0.03). Resistive index (RI) was greater in G200 than in G100 (p = 0.02). RI was lower in Day 12 than Day 15 (p = 0.02). Pulsatility index (PI) was greater on Days 14 and 15 (p < 0.01). In conclusion, the lowest dose of pFSH (100 mg) can be considered sufficient for an efficient superovulatory response in sheep, producing better CLs development dynamic in early luteal phase and ovarian blood perfusion and smaller number of PRCL than the traditional (200 mg) pFSH dose. [ABSTRACT FROM AUTHOR]

The aim was to evaluate if medetomidine and dexmedetomidine affected arterial ovarian blood flow in dogs. The dogs were randomly assigned to two different groups. In Group 1, medetomidine (10 µg/kg) was administered intramuscularly and, in Group 2, dexmedetomidine (5 µg/kg) was used. After a preliminary exam, arterial blood pressure (BP) was measured and a duplex Doppler ultrasonographic examination of both ovarian arteries was performed. Twenty minutes after the administration of medetomidine or dexmedetomidine, BP and ovarian Doppler ultrasonography were repeated. High quality tracings of ovarian artery flow velocity were obtained in all dogs and Doppler parameters: Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV) and Resistive Index (RI) were measured before and after drug administration in the left (LO) and right (RO) ovaries. PSV and EDV values decreased significantly after drug administration (p < 0.05) compared to the non-sedated values, but no differences were found between the LO and RO (p > 0.05). The RI was not affected by drugs administration in neither of the groups studied (p > 0.05). In conclusion, the administration of medetomidine or dexmedetomidine causes a decrease in blood flow velocity in the ovarian artery and may be a good choice to avoid excessive bleeding prior surgeries in which ovariectomy.

BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women. The assessment of uterine and ovarian artery resistance indices (RI) can provide additional information on pathophysiology of the syndrome, and can be applied as a diagnosis criterion in suspected cases of PCOS. This study aims to compare the parameters of uterine artery blood flow and ovarian stromal artery in PCOS patients and healthy women. METHODS: This cross-sectional study was performed on 20 women with PCOS (PCOS group) and 20 healthy women (control group). In the initial evaluations, age, body mass index, levels of follicle stimulating and luteinizing hormones, as well as severity of hirsutism and acne were recorded. Then, ovarian volume, uterine and ovarian artery RI and the rate of vascularization of ovarian stromal arteries were measured and compared with each other using Gray-scale and color Doppler sonography (CDS). FINDINGS: Uterine artery RI on both sides in the PCOS patients (94%) was significantly higher than the healthy women (86%) (p

Abstract Doppler ultrasonography enabled understanding of the reproductive system hemodynamics in cyclic and pregnant cattle. To confirm the hypothesis that the ipsilateral ovarian and uterine arterial blood flows to the ovulating ovary are higher than the contralateral one along days and phases (follicular, early luteal, mid-luteal, late luteal) of the estrous cycle, eight cyclic spontaneously ovulating cows were scanned with Doppler ultrasound each other day along three oestrous cycles to monitor the follicular dynamics, the vascularization of the ovulatory follicle (OF), the corpus luteum (CL) developmental dynamics, the ipsilateral and the contralateral ovarian and uterine arterial diameters and their blood flow. Results proved the hypothesis. Both days and phases of the estrus cycle influenced (P = 0.0001) the follicular dynamic, the luteal hemodynamics, the ovarian and uterine hemodynamic. The ovulatory wave and the mid-luteal non-ovulatory wave had expanding numbers and the diameters of small, medium and large follicles. Though area, antral area, vascularization area of the OF ascended from Day −4 to the day of ovulation (Day 0), but the percent of its vascularization area and that of granulose layer increased till Day −3. The CL diameter increase till Day 15, and its vascularization area increased till Day 13, but its% of vascularization area ascended (P = 0.0001) from Days 1–4 and declined from Days 9–13. Both RI and PI of the ipsilateral ovarian artery were lower than the contralateral one; but, both obtained high values during the follicular phase. A linear increase (P = 0.0001) of uterine horns vascularization area and both ovarian and uterine arteries diameters, PSV and EDV from follicular to late luteal phases accompanied a linear decrease of their PI and RI. In conclusion, the ovarian and uterine blood flows vary according to the estrous day, estrous phase, the ovulating ovary, ovulatory follicle growth and corpus luteum developmental stage. Highlights • Ovarian ipsilateral blood flow is higher than contralateral along estrous cycle. • Uterine ipsilateral blood flow is higher than contralateral along estrous cycle. • Ipsilateral and contralateral uterine and ovarian blood flows highly correlated. • Both blood flow indices of ovarian and uterine significantly vary except ovarian RI. • The ovarian and uterine blood flows are higher after ovulation than pre-ovulation. [ABSTRACT FROM AUTHOR]

Abstract: Rupture of an ovarian artery aneurysm in the peripartum period occurs in both traumatic and atraumatic settings. To our knowledge, this is the first reported case of spontaneous atraumatic rupture of the bilateral ovarian arteries. This report describes a multiparous recently post‐partum patient with abdominal pain and signs of hemodynamic compromise, the sequela of hemoperitoneum from ruptured bilateral ovarian arteries. With a multidisciplinary approach, this patient was successfully treated with transarterial embolization. [ABSTRACT FROM AUTHOR]