1/70. uterine artery embolization--a successful treatment to control bleeding cervical pregnancy with a simultaneous intrauterine gestation.A case of a woman suffering from a bleeding heterotopic cervical pregnancy is described. The concurrent cervical pregnancy and intrauterine gestation were diagnosed by ultrasound and bleeding was initially controlled with selective fluoroscopic uterine artery embolization. A selective fetal reduction was done with ultrasound-guided intracardiac potassium chloride. uterine artery embolization has been used successfully to control haemorrhage in cervical pregnancies when the main goal was to allow preservation of the uterus, thus maintaining potential fertility. This is the first report of arterial embolization used to control bleeding for maintaining a concurrent intrauterine heterotopic pregnancy in an in-vitro fertilization patient. Unfortunately, subsequent conservative measures led to undesired outcome. This procedure initially controlled the bleeding without disrupting the intrauterine fetal cardiac activity.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/70. choriocarcinoma co-existent with an intact pregnancy: case report and review of the literature.A patient presenting with antepartum haemorrhage due to a vaginal metastasis of choriocarcinoma is reported. Following delivery she was successfully treated with chemotherapy and surgery. This report details this unusual presentation and reviews the literature on this rare condition.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
3/70. Oral contraceptives: a cause of hyperbilirubinemia in stem cell transplant patients.Conjugated hyperbilirubinemia in the clinical setting of hematopoietic stem cell transplantation can have multiple etiologies that may prompt various therapeutic interventions. Two patients who received short courses of a high-dose estrogen-progesterone combination to treat breakthrough menstrual bleeding during transplant are reported. Conjugated hyperbilirubinemia developed in both patients within days of beginning therapy and resolved after the ethinyl estradiol and norgestrel (Ovral; Pharmacia and Upjohn, Kalamazoo, MI, U.S.A.) was discontinued. In one of the patients, this occurred on three separate occasions during the course of transplantation. Recognizing the cholestatic effect of estrogens during transplantation may prevent unnecessary alterations in therapy beyond the simple discontinuation of these medications.- - - - - - - - - - ranking = 4.1204620354761E-5keywords = stem (Clic here for more details about this article) |
4/70. Twin pregnancy with a complete hydatidiform mole and co-existing fetus following in-vitro fertilization: case report.hydatidiform mole with a co-existing live fetus is a rare event. We report the case of a 41 year old Caucasian woman who attended for in-vitro fertilization. Three embryos, containing two apparently normal pronuclei, were transferred into the uterus. A twin pregnancy with a live fetus and a complete mole ensued. The pregnancy was managed conservatively until 28 weeks gestation when, following an episode of major antepartum haemorrhage, a live female infant was delivered by Caesarean section. The mole, weighing over 1.7 kg, was successfully evacuated. Following delivery, serum human chorionic gonadotrophin concentrations returned to baseline and remain within the normal range at 24 months. Both mother and daughter are well on assessment 24 months later.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/70. Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system.adenomyosis is an important cause of menorrhagia. Besides hysterectomy, the treatment options for adenomyosis have been limited. Presented here is the successful treatment of adenomyosis in a woman presenting with menorrhagia, dysmenorrhea, and an enlarging uterus, for whom conservative therapy initiated with mefenamic acid was unsatisfactory. The patient had insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS). A marked decrease in uterine size occurred within 12 months of insertion accompanied by resolution of the menorrhagia and dysmenorrhea. Thus, the LNG-IUS is a viable option and represents a real advance in the treatment of adenomyosis.- - - - - - - - - - ranking = 4.1204620354761E-5keywords = stem (Clic here for more details about this article) |
6/70. Non-Hodgkin's lymphomas involving the uterus: a clinicopathologic analysis of 26 cases.Non-Hodgkin's lymphomas (NHL) involving the uterus may be either low-stage neoplasms that probably arise in the uterus (primary) or systemic neoplasms with secondary involvement. In this study, 26 NHL involving the uterus are reported. Ten cases were stage I(E) or II(E) and are presumed to be primary. The mean age of patients at presentation was 55 years (range, 35 to 67 years), and abnormal uterine bleeding was the most frequent complaint (six patients). Nine of 10 tumors involved the cervix. Histologically, eight were diffuse large B-cell lymphoma (DLBCL); one was follicle center lymphoma, follicular, grade 1; and one was marginal zone B-cell lymphoma. At 5 years of clinical follow-up, five of six patients were alive after treatment. In 12 cases, uterine involvement was part of a systemic disease at diagnosis, either stage III(E) or IV. The mean patient age at the time that uterine involvement was detected was 58 years (range, 22 to 75 years); 6 of 12 had abnormal uterine bleeding. Six tumors involved both cervix and corpus, four corpus, and two cervix. Six were DLBCL; two were small lymphocytic lymphoma; three were follicle center lymphoma, follicular, grade 1 (two cases) or grade 2 (one case); and one was precursor T-cell lymphoblastic lymphoma. At 5 years of clinical follow-up, two of seven patients were alive after treatment. Four DLBCL arose in patients with incomplete clinical information; therefore, stage is unknown. We conclude that low-stage (presumably primary) uterine NHL are most commonly DLBCL, predominantly arise in the cervix, and cause abnormal uterine bleeding. High-stage NHL are a heterogeneous group of B-cell neoplasms that can involve the cervix or the corpus.- - - - - - - - - - ranking = 1.6481848141905E-5keywords = stem (Clic here for more details about this article) |
7/70. Intrauterine polyps--a cause of unscheduled bleeding in women using the levonorgestrel intrauterine system: case report.The levonorgestrel intrauterine releasing system is a contraceptive that has been shown to reduce menstrual blood loss dramatically. Breakthrough bleeding, however, is a relatively common occurrence as with all methods of progestogen-only contraception and this limits its acceptability for women. Amenorrhoea can be achieved in the majority of women within 12 months of insertion. Any new pattern of bleeding after amenorrhoea or a persistence of heavy bleeding may be due to co-existing intrauterine pathology such as endometrial polyps. The use of out-patient techniques such as hysteroscopy and saline infusion sonography are indicated in these instances to exclude other intrauterine pathology.- - - - - - - - - - ranking = 4.1204620354761E-5keywords = stem (Clic here for more details about this article) |
8/70. A cervical ectopic pregnancy managed by medical treatment and angiographic embolization.Medical treatment in the form of systemic methotrexate with or without local methotrexate/potassium chloride is effective for early cervical pregnancy. It should be the treatment of choice in suitable cases. Haemorrhagic complications can be effectively managed by angiographic embolization. A case report illustrating these points is presented.- - - - - - - - - - ranking = 8.2409240709523E-6keywords = stem (Clic here for more details about this article) |
9/70. fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: case report.Bilateral ligation of internal iliac (hypogastric) arteries (BIL) is a life-saving operation in cases of massive obstetric haemorrhage. This operation preserves reproductive function as opposed to the more commonly performed emergency hysterectomy in such situations. We report on effectiveness and future fertility in 12 women who had internal iliac ligation to control severe obstetric haemorrhage: in 10 out of the 12 women, BIL was successful. Of the two women who subsequently needed emergency hysterectomy, one woman died of disseminated intravascular coagulation. Of the eight women we were able to follow-up to assess reproductive performance, two did not desire future fertility. Three had subsequent pregnancies (50%), of whom two proceeded to term. We conclude that BIL is a safe and effective procedure for treating life-threatening obstetric haemorrhage with preservation of future fertility. This technique should be performed more often when indicated.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
10/70. (A)symptomatic necrotizing arteritis of the female genital tract.AIMS: The vasculitides represent a heterogenous set of disorders that differ in prognosis and response to therapy. Beside systemic vasculitides, the development of localized forms of arteritis is well known though uncommon and the etiopathogenesis is not yet definitely clear. methods: patients with necrotizing arteritis of the female genital tract proven by histology are studied in a retrospective analysis. RESULTS: Three cases of necrotizing arteritis with histological features of panarteritis nodosa apparently confined to the female genital tract are presented. None of these patients had prior history of systemic vasculitis. The acute necrotizing vasculitis was confined only to the uterine cervix in two patients and involved all the internal genital organs in the third patient. The patients have been observed for up to 4 years without any therapy for these lesions and without any manifestation of systemic vasculitic progression. CONCLUSION: It is to speculate that focal arteritis of the female genital tract is a benign form of panarteritis nodosa or moreover a totally different entity with identical morphogenesis but possibly different pathogenesis. Furthermore it seems to be important to be aware of the specificity of focal arteritis in female genital tract as distinct from the generalized form to prevent unnecessary surgical or chemotherapeutical therapy for this lesion. The benign entity of local arteritis in the female genital tract is discussed in contrast to the severe prognosis of systemic panarteritis nodosa.- - - - - - - - - - ranking = 3.2963696283809E-5keywords = stem (Clic here for more details about this article) |
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