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991.
John P. Micha Mark A. Rettenmaier Matthew Clark Jim C. Hu Miles Chang John V. BrownIII Bram H. Goldstein 《Gynecological surgery》2008,5(1):49-51
Persistent uterine prolapse with secondary acute renal failure is a very uncommon event. We report the case of a 77-year-old
woman with a 5-year history of uterine prolapse. She was referred to our gynecologic oncology service for 3rd degree uterine
prolapse and was found to have bilateral hydronephrosis and acute renal insufficiency. The patient was fitted for a pessary
to manage the uterine prolapse, which resulted in resolution of her hydronephrosis and renal insufficiency. Prompt assessment
with nephrology consultation and pessary placement for patients with 3rd degree genital prolapse is imperative to ensure that
irreversible renal complications do not manifest themselves.
This study was supported by a grant from the Women’s Cancer Research Foundation. 相似文献
992.
993.
Tamandani DM Sobti RC Shekari M Kaur S Huria A 《Archives of gynecology and obstetrics》2008,277(6):527-533
Introduction Cervical cancer, the second most common malignancy in women worldwide, is almost invariably associated with infection by human
papillomavirus (HPV). However, although many women are infected with high-risk types of HPV, only a subset of infected women
will ever develop cervical cancer. Therefore, host genetic factor may play a role in cervical carcinogenesis. Several studies
suggested that immunological components play a key role in the development of cervical cancer. Polymorphism in the IL-1RA gene was associated with various malignant diseases. Data are lacking for cervical cancer.
Materials and methods In a case−control study we analyzed the polymorphism of IL-1RA in 150 women with cervical cancer and 209 healthy controls. Genomic DNA fragments were amplified by PCR.
Results There was a strong significantly protective association between heterozygous AB genotype and HPV 18 (OR = 0.11, 95% CI = 0.04–0.30, p = 0.0000000). Similarly this result was demonstrated, in combined AB + BB genotypes of IL-1RA with HPV 18 (OR = 0.12, 95% CI = 0.05–0.30, p = 0.0000000) and HPV type 16 + 18 (OR = 0.18,95% CI = 0.08–0.38, p = 0.000005). We found high protective significant association between heterozygous genotype AB with adenocarcinoma (OR = 0.19, 95% CI = 0.09–0.40, p = 0.0000002) as well.
Conclusion These findings therefore suggest that the IL1-RA polymorphism is associated with cervical cancer. 相似文献
994.
Zampieri N Borruto F Zamboni C Camoglio FS 《Archives of gynecology and obstetrics》2008,277(4):303-306
Background Abdominal cystic formations in newborns are relatively common and often diagnostic suspicion arises in this regard even before
birth as a result of ultrasound scans carried out during pregnancy. The aim of this study is to highlight the problems posed
by the prenatal diagnosis of abdominal cysts in order to outline the most appropriate therapeutic approach in case of suspected
ovarian cysts.
Materials and methods Between January 2003 and January 2007, 57 women were enrolled in this study for a prenatal ultrasound (US) that revealed the
presence of an echo-rare or echo-free area in the foetal abdomen. After birth all babies underwent blood tests and abdominal
US scans in order to confirm or identify the nature of the cyst. If abdominal US could not show the nature of the cystic formation,
magnetic resonance imaging with sedation was performed. When the radiological tests were not useful to identify the nature
of the cysts and surgery was then necessary, surgical procedures were performed with laparoscopy.
Results Ultrasounds were useful to identify the diameter of the cysts but not all their origins; also MRI confirmed the morphology
and volume of the cysts, but could not give further details about their origin.
Discussion Abdominal ultrasound and finally laparoscopy used to treat and remove the cysts were useful to monitor all simple abdominal
cysts. MRI seemed not to be useful for the treatment of this condition, especially in the pediatric age when mild sedation
is required. 相似文献
995.
Background Obesity continues to be a global epidemic, and strong evidence exists linking it with gestational complications such as macrosomia,
hypertensive disorders of pregnancy, gestational diabetes, and cesarean section. Bariatric surgery, a highly effective treatment
for obesity, may prevent such complications in subsequent pregnancies.
Objective This review seeks to describe the risks and benefits of post-bariatric procedure pregnancies, in comparison to both community
and obese cohorts.
Results A thorough review of the literature suggests that post-surgery women are not at increased risk for poor perinatal outcomes,
and moreover their risks for many obesity-related gestational complications are reduced after bariatric surgery. Data regarding
fertility after bariatric surgery are quite ambiguous, however, and studies exist demonstrating both positive and negative
associations between weight loss procedures and fertility.
Conclusions Clinicians should be aware that data collected on this subject were often gathered from post-op pregnant women provided with
good prenatal care and screening for nutritional deficiencies. Although pregnancy after bariatric surgery appears to be safe,
providers should take extra care to properly monitor their post-op pregnant patients for appropriate weight gain and nourishment. 相似文献
996.
Objective To investigate obstetric outcomes in singleton pregnancies conceived by in vitro fertilization (IVF) to nulliparous women
older than 35 compared to those of their younger counterparts.
Methods Nulliparous women 35 years and older at delivery conceived by IVF (n = 89) were compared with nulliparous women 34 years and younger at delivery conceived by IVF (n = 48). Data included antenatal data, gestational age at delivery, maternal and neonatal complications and mode of delivery.
Results The incidence of pregnancy-induced hypertension in the younger group was significantly higher than that in the elderly group
(13 vs. 3.4%, P = 0.043). There were no measurable differences in other obstetric outcomes such as placental abnormality, premature delivery
or neonatal asphyxia between the two groups.
Conclusion The current results suggest that obstetric complications in pregnancies conceived IVF are attributed to mechanisms other than
those depend on advanced maternal age. 相似文献
997.
Saglam A Bozdag G Kuzey GM Kuçukali T Ayhan A 《Archives of gynecology and obstetrics》2008,277(6):557-562
Objective To present a unique case of a 63 year-old woman with coexistent adenocarcinoma of the ovary, endometrium, cervix and fallopian
tube.
Materials and methods A case report from a tertiary health center.
Results A woman presenting with postmenopausal bleeding and abdominal distantion was assessed by endometrial biopsy and explorative
surgery. The frozen section of the mass on the right adnex revealed malign mucinous carcinoma of the ovary. As usual, optimal
debulking was performed as initial surgical staging procedure of ovarian cancer. The microscopic examination of the right
ovary revealed a typical mucinous cystadenocarcinoma. Furthermore, the focal endometrial irregularity at the left uterine
cornus turned out to be a well differentiated endometrial carcinoma of the endometrioid type with <1/3 myometrial invasion.
The pale infiltrative lesion in the cervix also turned out to be an adenocarcinoma of the endocervical type with deep stromal
invasion and areas of diffuse glandular dysplasia and in-situ glandular neoplasia at the periphery. Besides, several sections
from the left fallopian tube uncovered diffuse dysplasia in the lining epithelium and a focus of adenocarcinoma with papillary
and cribriform pattern.
Discussion When compared with patients having metastatic lesions, most synchronous female malignancies are accompanied with early stage
and low-grade with a more favorable prognosis. However, there is paucity of data for the exact criterion to distinguish primary
tumors from metastatic lesions. In such cases, the validity of immunohistochemical and cloning studies are not clear. 相似文献
998.
Morimatsu Y Matsubara S Hirose N Ohkuchi A Izumi A Ozaki K Ozawa K Suzuki M 《Archives of gynecology and obstetrics》2008,277(3):267-270
Background Disseminated intravascular coagulation (DIC) caused by placental abruption usually improves rapidly after prompt delivery
and adequate anti-DIC treatment.
Case A 30-year-old nulliparous woman suffered from placental abruption at the 25th week of pregnancy, and emergent cesarean section
was done immediately. She exhibited DIC, which continued even after termination of the pregnancy and anti-DIC treatment. She
also showed neutropenia. We closely observed her, and at the 58th day postpartum, blast cells appeared in the peripheral blood
and she was diagnosed with acute promyelocytic leukemia (APL). Induction chemotherapy was done successfully. The close observation
after delivery enabled us to make the prompt diagnosis/treatment, leading to the complete remission.
Conclusion APL should be added to the list of differential diagnosis when DIC persists even after prompt delivery and appropriate anti-DIC
treatment after placental abruption. 相似文献
999.
Objectives To establish reference ranges for maternal serum inhibin A in normal first trimester pregnant women.
Materials and methods This was a cross-sectional study. We measured maternal serum inhibin A in normal pregnant women gestation age between 6+0 and 14+6 weeks using the enzyme-linked immunosorbent assay (ELISA) method. Maternal serum inhibin A was analyzed according to gestational
ages (GA).
Results Serum of 300 pregnancies was analyzed and the outcome demonstrated the median of maternal serum inhibin A according to gestational
age. The levels of maternal serum inhibin A during the 60–6+6 week of gestations are lowest when compared with other gestational age. The levels of maternal serum inhibin A during 90–9+6 week of gestations are maximal. Maternal serum inhibin A then declined until 14 weeks of gestation.
Conclusion Serum inhibin A can be measured during the first trimester of pregnancy by using the recent ELISA technique. Our reference
ranges might be useful for further studies, such as prediction of adverse pregnancy outcome in threatened abortion. 相似文献
1000.
Brimacombe M Iffy L Apuzzio JJ Varadi V Nagy B Raju V Portuondo N 《Archives of gynecology and obstetrics》2008,277(5):415-422
On the basis of 333 documented cases of permanent perinatal neurological damage, associated with arrest of the shoulders at
birth, the authors conducted a retrospective study in order to evaluate the predisposing role, if any, of the utilization
of extraction instruments. The investigation revealed that 35% of all injuries occurred in neonates delivered by forceps,
ventouse or sequential ventouse–forceps procedures. This frequency was several-fold higher than the prevailing instrument
use in the practices of American obstetricians during the same years. A high rate of forceps and ventouse extractions was
demonstrable in all birth weight categories. Average weight and moderately large for gestational age fetuses underwent instrumental
extractions more often than grossly macrosomic ones. This circumstance indicates that forceps and ventouse are independent
risk factors, unrelated to fetal size. Their use entailed central nervous system injuries significantly more often than did
spontaneous deliveries. The findings suggest that extraction procedures may be as important as macrosomia among the factors
that lead to neurological damage in the child in connection with shoulder dystocia. Because they augment the intrinsic dangers
of excessive fetal size exponentially, the authors consider their use in case of ≥4,000 g estimated fetal weight inadvisable.
Sequential forceps–ventouse utilization further doubles the risks and is, therefore, to be avoided in all circumstances. 相似文献