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991.
Kilic-Okman T Yardim T Gücer F Altaner S Yuce MA 《Archives of gynecology and obstetrics》2008,278(1):75-77
BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation. Patients with PJS have increased risk for gastrointestinal, breast, and female genital tract cancers. CASE: Multiple genital tract cancers in a 34-year-old woman with PJS are described. The patient, who was admitted to our department with severe vaginal bleeding, was performed right salpingo-oophorectomy because of pure gonadoblastoma in 1996. In 2003, concomitant to cervical carcinoma, breast cancer was diagnosed. Patient underwent left modified radical mastectomy due to the invasive papillary carcinoma. The patient received six cycles combination chemotherapy and radiation therapy because of stage IIIB cervical cancer. CONCLUSION(S): This is the first case report presenting PJS associated with multiple genital tract tumors including ovarian gonadoblastoma in literature. The clinical significance of these tumors in PJS patients has been reviewed. 相似文献
992.
Gupta N Singh N Sarangi S Dalmia S Mittal S 《Archives of gynecology and obstetrics》2008,278(2):169-170
INTRODUCTION: Tuberous sclerosis is an autosomal dominant disorder of hamartoma formation that can manifest as cardiac or central nervous system lesions and adversely affect maternal and fetal outcome. CASE REPORT: We report a case of maternal tuberous sclerosis with fetal cardiac rhabdomyoma detected in utero at 26 weeks gestation. CONCLUSION: To conclude, a pregnancy complicated by maternal or fetal tuberous sclerosis deserves careful vigilance and the fetus should undergo prenatal fetal Doppler echocardiography and if possible an MRI, so that parents can be counseled regarding its future prognostic implications. 相似文献
993.
Filariasis is a helminthic infection caused by tissue nematodes. It is estimated that at least 120 million people are infected
worldwide and another 1 billion are “at risk” of infection. The prevalence is increasing due to uncontrolled urbanization
in many of the endemic countries. The geographical distribution is determined mainly by climate and the distribution of the
mosquito vector. We report a case of huge filarial elephantiasis of the vulva, in a 40-year-old multipara with background
history of secondary infertility. She had excision of the elephantoid vulva lesion under general anaesthesia. A nontender
irreducible pedunculated mass (25 cm × 21 cm) with a large stalk arising from the right groin down to the ipsilateral labia
majora was removed. A similar mass on the left groin, measuring 10 cm × 6 cm was removed. Diagnosis was confirmed at histopathologic
analysis of the excised masses. Patient was placed on diethyl carbamazine. 相似文献
994.
Simsek A Celen S Islimye M Danisman N Buyukkagnici U 《Archives of gynecology and obstetrics》2008,278(6):559-563
Objective
We sought to determine whether meconium-stained amniotic fluid is based on chronic hypoxia or not? In case of chronic hypoxia, higher red blood cell (Rbc) count and/or total hemoglobin levels (Hgb) and/or higher fetal hemoglobin (HbF) and/or lower adult hemoglobin (HbA) levels were expected when compared with controls.Design
Case–control study.Setting
Obstetric unit of a tertiary ministry of health hospital.Sample
Fifty singleton pregnancies with meconium-stained amniotic fluid and 50 singleton pregnancies with clear amniotic fluid at all stages of labor.Methods
Umbilical cord blood samples were collected for determination of total blood parameters and hemoglobin electrophoresis.Main outcome measures
Red blood cell count, total hemoglobin, fetal and adult hemoglobin contents (HbF and HbA).Results
Red blood cell count, total hemoglobin, fetal hemoglobin (HbF) and adult hemoglobin (HbA) contents were not different between meconium stained and clear amniotic fluid groups.Conclusion
These results suggest that meconium passage may not be associated with chronic fetal hypoxia as demonstrated by similar red blood cell count, total hemoglobin values and fetal hemoglobin (HbF) and adult hemoglobin (HbA) contents.995.
Pregnancy and tuberculosis (TB) To assess TB cases during pregnancy in a developing region retrospectively and to present two case reports.
Objectives Since TB cases activated by HIV infection during pregnancy are well reported in the literature, we aimed to investigate the
aggressiveness of pulmonary TB among pregnant women and to assess the effects of TB on the fetus in Kutahya, an area where
HIV positive cases are not seen.
Materials and methods The medical records between 2000 and 2005 of the Provincial Health Directorate and Dispensary Against Tuberculosis in Kutahya
were reviewed and analyzed retrospectively.
Results Between 2000 and 2005, 667 pulmonary TB cases were examined in the Kutahya region. Of these, 106 occurred in women at reproductive
ages between 20 and 44. All were HIV negative cases. In this area, five TB cases were found during pregnancy. There were three
cases seen in the first trimester, but pregnancy was ended by curettage. Two women had pulmonary TB and gave birth. Five cases
were evaluated as class 1 TB. During and after pregnancy, isoniazid, rifampin, ethambutol, and pyrazinamide (INH + RFP + ETB + PRZ)
were used for the treatment. Resistance to anti-TB drugs was not seen during the treatment. Neither congenial nor neonatal
TB was seen.
Conclusion Generally, TB is expected to be more aggressive during pregnancy. Since our cases were HIV negative, it can be thought that
TB did not progress aggressively. Less aggressiveness and non-resistance to TB treatment in HIV-negative pregnant women compared
with HIV-positive women were observed. Therefore, HIV infection results in greater mortality than the triple combination of
human immunodeficiency virus, mycobacterium TB, and pregnancy. Besides, the advance of TB in pregnant women was not different
from that in non-pregnant women in Kutahya. The fetus and the newborn were not affected. INH, RFP, ETB, and PRZ were used
for therapy. 相似文献
996.
Peled Y Yogev Y Kahn A Mashiach R Berant M Pardo J 《Archives of gynecology and obstetrics》2008,278(3):237-239
Objective Correct prenatal determination of the fetal right/left axis is essential for the diagnosis of fetal malformations, in particular
congenital heart anomalies. A reliable method of transabdominal echocardiographic assessment of the fetal situs in the late
second trimester was established. We aimed to determine the validity of the transvaginal approach to assess fetal axis.
Method The study group consisted of 108 consecutive women in the second trimester of a singleton pregnancy, undergoing elective transvaginal
anatomy scans. All had undergone previous transabdominal echocardiography to establish fetal axis. The same technique was
used to assess the fetal axis during the transvaginal study, and the findings were compared.
Results There was total agreement in fetal axis determination between transabdominal and transvaginal scans in all cases. The accuracy
of the transvaginal study was not affected by maternal obesity, fetal position or the presence of cardiac malformation (in
one case).
Conclusion Transvaginal ultrasonography is the reliable and accurate means of determining the fetal axis.
Both affiliations are affiliated with Sackler Faculty of Medicine, Tel Aviv
University. 相似文献
997.
998.
Shekari M Sobti RC Kordi Tamandani DM Suri V 《Archives of gynecology and obstetrics》2008,278(6):517-524
Cervical cancer continues to be the most common cause of death among women in developing countries. Methylenetetrahydrofolate
reductase (MTHFR) and methionine synthase (MS) are critical enzymes of folate metabolic pathways. In this work, we have conducted
a case–control study to assess the role of these two polymorphisms in cervical cancer development. We obtained blood samples
from 200 women with cervical cancer and from equal matched controls and analysed using PCR-RFLP method. We found that the
methylenetetrahydrofolate reductase variant CT and CT + TT genotypes decreased cervix cancer risk, statistically significant (OR:0.30, 95% CI: 0.18–0.51, P < 0.001 for CT and OR:0.29, 95% CI: 0.18–0.49, P = 0.0000006 for CT + TT). Similarly in those patients who used oral contraceptive with variant CT genotype, there was statistically highly significant reduced risk of cervix cancer (OR:0.25, 95% CI: –0.12–0.49, P < 0.001) of methylenetetrahydrofolate reductase gene. For the methionine synthase, 2756 variant AG and AG + GG genotypes were similarly associated with highly significant reduced risk of cervix cancer (OR: 0.13, 95% CI: 0.07–0.26, P < 0.001 for AG, and OR: 0.15, 95% CI: 0.08–0.27, P < 0.001 for AG + GG) genotypes. In conclusion, our study suggested that methylenetetrahydrofolate reductase and methionine synthase polymorphisms
might have protective effect on the risk of cervical cancer in the North Indian women. 相似文献
999.
Ghaemmaghami F Fatemeh G Behroozi S Shohreh B Mousavi A Azamolsadat M Ashrafgangooei T Tahereh A Gilani MM Mitra MG Behtash N Nadereh B Ghanbari Z Zinat G 《Archives of gynecology and obstetrics》2008,278(4):315-318
Background and goals This study is designed to survey gestational trophoblastic neoplasia with vaginal metastases (GTN + VM) manifestations, prognosis
and chemotherapy response in order to consider appropriate chemotherapy regimen for these patients. There have been just a
few studies about treatment of GTN + VM.
Materials and methods Patients with Stage III GTN with or without vaginal metastases who had referred to Vali-e-Asr Hospital during 1996–2006 have
been selected to take part in this study and the size of metastases was measured. Then response and resistance to single and
combination chemotherapy regimens have been compared in these two groups. The data were processed using SPSS system (release
10). Statistical analysis was done with X2 to determine factors associated with complete clinical response. The level of significance was assigned at P < .05.
Results Forty-eight patients with stage III (with pulmonary metastases) GTN patients have been selected, 13 with vaginal metastases
and 35 without vaginal metastases. Incidence of vaginal metastases in stage III was 26%. Metastases were mainly in distal
part of vagina and suburethra. Chief complaint was severe hemorrhage in 25% of patients and was controlled by vaginal packing
with just one exception. Group of vaginal metastases showed 66.6% resistance to first-line chemotherapy, compared to 28.6%
in patients with no vaginal metastases (P-value = 0.010). Median of chemotherapy courses in low-risk vaginal metastatic patients was 5 (mean = 5.2), compared to three
courses in the group without vaginal metastases. Resistance to single chemotherapy was significantly higher in GTN + VM versus
GTN without VM patients and resistance was higher especially in patients with metastases with more than 3 cm (in diameter).
Conclusions Vaginal metastasis with more than 3 cm in diameter is an important prognostic factor in GTN patients. There have higher risks
for severe hemorrhage and resistance to single agent chemotherapy, so in these patients combination chemotherapy, with no
regard to staging and scoring, would be a better choice.
An erratum to this article can be found at 相似文献
1000.
Matsubara S Izumi A Nagai T Kikkawa I Suzuki M 《Archives of gynecology and obstetrics》2008,278(2):195-197
BACKGROUND: While vaginal breech delivery, although rare, can cause femur fracture, abdominal breech delivery is not expected to cause it. CASE: A 2,490-g female infant was delivered at term by elective cesarean section for breech presentation. She sustained a fracture of the femur shaft. A simple splinting led to a complete healing of the fracture without sequelae. CONCLUSION: Although abdominal breech delivery reduces the risk of birth trauma, we must be aware that femur fracture can occur regardless of the mode of delivery. 相似文献