1/371. Uterine malignant leiomyoblastoma (epithelioid leiomyosarcoma) during pregnancy.A case of uterine malignant leiomyoblastoma (UML) which was initially mistaken for uterine leiomyoma on two different occasions is presented. About 20 cases of uterine leiomyoblastoma taking a malignant course have been described in the literature. This case of UML is the first diagnosed during pregnancy. In retrospect, tumor tissue removed from the uterus 4 years earlier already showed histological signs of UML. The large and metastatic tumor showed nuclear atypia, a moderate mitotic index, and tumor cell necrosis, indicating malignancy. Treatment consisted of hysterectomy, bilateral salpingo-oophorectomy, and debulking of most other tumor masses. In the literature, radio- and chemotherapy have not proved to be effective in these tumors. Hormonal therapy has only been used in 2 patients. In this patient, hormonal influence on tumor growth may be substantial. The tumor was progesterone- and estrogen-receptor positive and increased in size rapidly during pregnancy. Since little is known about these tumors further studies are necessary to evaluate hormonal influences both as a causative factor and as a therapeutic possibility.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/371. molar pregnancy presenting with hyperemesis gravidarum.nausea and vomiting are common complaints in pregnancy, occurring in more than 50% of pregnant women. Occasionally, the vomiting becomes severe and persistent enough to develop into the syndrome called hyperemesis gravidarum and sometimes requires hospitalization. A 20-year-old woman presented with hyperemesis gravidarum, which was later found to be associated with a molar pregnancy. hyperemesis gravidarum is reported to occur in as many as 26% of molar pregnancies. Increases in the level of serum beta-human chorionic gonadotropin may be the mechanism of hyperemesis gravidarum in molar pregnancy. Hyperthyroid states linked to molar pregnancy may further exacerbate hyperemesis gravidarum. physicians should be aware of this possibility of molar pregnancy in all patients with hyperemesis gravidarum and be familiar with the appropriate management to monitor and prevent an often-fatal trophoblastic neoplasm.- - - - - - - - - - ranking = 1.5keywords = pregnancy (Clic here for more details about this article) |
3/371. Delivery of a severely anaemic fetus after partial molar pregnancy: clinical and ultrasonographic findings.The incidence of a normal live fetus and a partial molar placenta is extremely rare. Although triploidy is the most frequent association, a fetus with normal karyotype can survive in cases of partial molar pregnancy. We report a case of partial molar placenta in which a live female baby was delivered at 32 weeks gestation by a 30-year-old woman. At the 18th week, ultrasonographic examination revealed a normal fetus with a huge, multicystic placenta. Chromosomal evaluation by amniocentesis revealed a normal female karyotype (46,XX), and serial biometric measurement of the fetus showed normal growth during pregnancy. There were no obstetric complications until the 32nd gestational week when preterm rupture of the membranes occurred. The electronic fetal heart beat tracing showed a repeated sinusoid pattern and late deceleration after admission. The patient underwent emergency Caesarean section and delivered a 1551-g, anaemic female baby with an apgar score of 1, 4 and 6 at 1, 5 and 10 min, respectively. The baby recovered within 2 weeks after respiratory support and transfusion of packed red blood cells. Although anaemia is one of the risk factors that jeopardize the fetus in the case of partial molar pregnancy, termination is not indicated when the fetus is normal and no complications have occurred.- - - - - - - - - - ranking = 1.1666666666667keywords = pregnancy (Clic here for more details about this article) |
4/371. Term twin pregnancy with hydatidiform mole and a normal fetus.A term twin pregnancy with a complete hydatidiform mole and a normal live fetus is reported.- - - - - - - - - - ranking = 0.83333333333333keywords = pregnancy (Clic here for more details about this article) |
5/371. Prognostic factors and treatment for placental site trophoblastic tumor-report of 3 cases and analysis of 88 cases.OBJECTIVE: In order to understand the prognostic factors of placental site trophoblastic tumors (PSTT), we performed a medline search for cases from 1976 through 1998 and report three cases. MATERIALS AND methods: The patients' age at presentation, antecedent pregnancies, and responses to treatment were analyzed according to the extent of disease, disease status after treatment, and survival in 88 cases. RESULTS: patients with disease extending outside the uterus at presentation had a median latency of 24 months between the antecedent pregnancy and presentation of PSTT, which was significantly longer than that of 12 months in those with disease confined to the uterus. patients with metastatic diseases were 3 years older than patients with diseases confined to the uterus and had a higher incidence of term delivery as their antecedent pregnancy. The outcomes of patients with FIGO stage I-II disease after hysterectomy were excellent, while those with FIGO stage III-IV diseases had a 30% survival. Although initial partial responses to chemotherapy were observed in some patients, only 5 patients achieved a complete remission and 3 of these 5 received a combination of etoposide, methotrexate, and actinomycin-D, alternating with cyclophosphamide and vincristine. CONCLUSION: FIGO stage is the most important prognostic factor, and complete removal of all lesions provided good outcomes in PSTT patients. For those with unresectable tumors, combination chemotherapy showed a high response rate, but only a few achieved a complete response.- - - - - - - - - - ranking = 0.33333333333333keywords = pregnancy (Clic here for more details about this article) |
6/371. pregnancy with primary tubal placental site trophoblastic tumor--A case report and literature review.Placental site trophoblastic tumor (PSTT) is a rare trophoblastic neoplasm with malignant potential. The diagnosis and prognosis of this rare disease remain difficult. A case of tubal PSTT with the primary manifestation of internal bleeding at 30 weeks' gestation is presented. Emergency exploratory laparotomy and right partial salpingectomy were performed initially. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were done immediately after cesarean section at 34 weeks' gestation. No further adjuvant therapy was given after surgery. No evidence of tumor recurrence or signs of metastasis were noted during 12 months of follow-up. Heterotopic pregnancy, one with intrauterine normal pregnancy and the other with implanting in the right fallopian tube and placental site trophoblastic tumor transformation, was proposed. To our knowledge, this is the first such case in the English literature.- - - - - - - - - - ranking = 0.33333333333333keywords = pregnancy (Clic here for more details about this article) |
7/371. Malignant trophoblastic disease following a twin pregnancy consisting of a complete hydatiform mole and a normal fetus and placenta. A case report.We report an unusual pregnancy with a complete hydatiform mole coexisting with a normal fetus and placenta. This report stresses the importance of a correct diagnosis and the dilemmas the clinician is faced with when managing such a case. Malignant trophoblastic disease occurs in 55% of complete hydatiform mole and fetus. Two-thirds require combination chemotherapy.- - - - - - - - - - ranking = 0.83333333333333keywords = pregnancy (Clic here for more details about this article) |
8/371. Large lower segment myoma--myomectomy at lower segment caesarean section--a report of two cases.Uterine leiomyoma is found in approximately 2% of pregnant women. One in ten women will have complications related to myoma in pregnancy. Myomectomy during pregnancy especially at Caesarean section is much discouraged in the literature. We present here 2 cases of large uterine myoma, situated in the anterior aspect of the lower segment, complicating pregnancy at term. Myomectomy in both instances allowed delivery of the fetus through the lower segment, making vaginal delivery in subsequent pregnancies possible.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
9/371. 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 = 0.66666666666667keywords = pregnancy (Clic here for more details about this article) |
10/371. Clinical management of a quadruplet pregnancy combining a triplet pregnancy with a classical hydatidiform mole: case report and review of literature.A 28-year-old Taiwanese woman who had received ovulation induction by clomiphene citrate (CC), follicular-stimulating hormone (FSH), and human chorionic gonadotrophin (hCG) treatment was diagnosed with a quadruplet pregnancy containing a hydatidiform mole and three fetuses at nine weeks' gestation. Expectant management failed to achieve any viable neonate due to massive antepartum haemorrhage and preterm delivery at 25 weeks' gestation. Five other cases previously reported involving quadruplets or triplets with a complete hydatidiform mole and two or three fetuses are reviewed. All cases ended as premature non-viable fetuses. Analysis of the clinical features, management, and outcome both in our patient and these reports suggest that more efficacious treatment planning, such as selective feticide, should be considered in order to improve the likelihood of attaining an advanced gestational age for a single fetus.- - - - - - - - - - ranking = 1.5keywords = pregnancy (Clic here for more details about this article) |
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