Predictive Value of Maternal Anemia in Cases of Fetal Growth Restriction | Author : Waleed M. Tawfik | Abstract | Full Text | Abstract :Anemia can be defined as a state of inadequate O2 delivery to tissues due to reduction of the O2 carrying capacity of blood practically, anemia is diagnosed when there is reduction in the hemoglobin concentration or haematocrit level below normal values.
Iron deficiency anemia is a major public health problem among women of reproductive age in most of developing countries approximately 50% of pregnant women and 35% of non-pregnant women are anemic.
These nutritional disorders, has profound negative effects on pregnancy outcome, health of mothers and babies.
The objective of this study: Is to evaluate the maternal anemia during pregnancy as a risk factor for fetal growth restriction.
The study was done this study conducted on 120 pregnant women. Pregnant women with inclusion criteria: Singleton pregnancy, Gestational age more than 28 week and Hb level less than 10mg/dl. We exclude multiple pregnancy, Gestational age less than 28 week, Hb level more than 10 mg/dl and other medical disorder with pregnancy.
The results of this study reveal the following: There was significant difference between group 1, 2, 3, 4 as regard to Hb level, (PCV), (MCV), (MCH), (MCHC), (Ht) and (CBC).
The restriction of fatal growth was significant lower in sever anemic patient rather than mild or moderate anemic patient
In conclusions: The result of this study shows that there was restriction of fatal growth was significantly high in severe anemic group than mild or moderate group also, incidence of low birth weight and risk of fatal morbidity or mortality was significantly high in sever anemic group than mild or moderate group. |
| Cervical ectopic pregnancy | Author : Olivia Dziadek | Abstract | Full Text | Abstract :We performed dilation and curettage and cervical balloon placement in a cervical ectopic pregnancy after treatment with Methotrexate, KCI and bilateral uterine artery embolization. A minimally invasive approach was used in the case as the patient desired future fertility. We present the potential challenges in management of cervical ectopic pregnancy as well as approaches to treatment. |
| Tubal patency after Laparoscopic salpingostomy versus Methotrexate therapy in undisturbed tubal pregnancy. | Author : Waleed M. Tawfik | Abstract | Full Text | Abstract :Future fertility after ectopic pregnancy is dependent on several factors, including age, history of infertility, history of previous EP, tubal rupture, and contralateral tubal lesion. Thus, it seems reasonable to assess tubal patency following a treatment of an ectopic pregnancy in those women who are willing to have future pregnancy.
Aimed to: Compare between tubal patency after methotrexate & laparoscopic salpingostomy.
The study included 72 patients equally divided in number into 2 main groups.
First group: (36cases) Tubal ectopic pregnancy treated by MXT therapy single or multiple doses. Single dose regimen (MTX 1.0 mg/kg or 50 mg/m2 i.m or multiple dose regimen (MTX 1.0 mg/kg i.m days (0,2,4,6).
Second group: - (36 cases) Tubal ectopic pregnancy treated by laparoscopic salpingostomy.
After 3 months, we used laparoscopy with administration of methylene blue (MB) as a marker to detect the tubal patency.
As regard to tubal patency, of 31 cases (86.1%) from 36 cases that treated by MTX were patent and 5 cases (13.9 %) were blocked. On the other side 21 cases (58.3 %) from 36 cases that treated by laparoscopic salpingostomy were patent and 15 cases (41.7 %) were blocked).
Conclusions:Methotrexate is better than laparoscopic salpingostomy in treating undisturbed tubal pregnancy. |
| Diagnosis and Management of Uterine Fibromyomas in the Obstetric Gynecology Department of the Regional Hospital of Labe. Guinea | Author : Boubacar Siddi Diallo | Abstract | Full Text | Abstract :Objectives: To calculate the frequency of uterine fibromyomas, to describe the epidemiological profile, to describe the management and to establish the prognosis of women with uterine fibromyomas in the gynaecology-obstetrics department of the Regional Hospital of Labé.
Methodology: This was a retrospective descriptive study lasting three (3) years from 1 January 2017 to 31 December 2019. All patients admitted and operated on in the department for uterine fibromyomas during the study period were included. Patients who were not operated for uterine fibromyomas in the department and incomplete records were not included. Our data were collected and analysed using Epi-Info software version 7.2.2.6. Word, Excel and Power point software from Pack office 2016 were used for data entry and presentation. The study involved a continuous series of 115 anaemic pregnant women. We proceeded with an exhaustive recruitment of pregnant women according to the criteria defined above.
Results: The frequency of uterine fibromyomas among gynaecological pathologies was 44.75%. The epidemiological profile was that of a 30-39% (40.87%), housewife (53.91%) and nulliparous (40%) woman. Pelvic pain was the dominant reason for consultation (75.65%) and 46.08% of patients had no particular history. Intramural or interstitial uterine fibromyomas were the most common (49.57%) and ultrasound was performed in all patients. The surgical indications were dominated by large polymyomatous uterus 37.39%, followed by haemorrhagic fibroid 26.09%. Myomectomy was performed in 75.65% of cases, exclusively via the abdominal route (100%), while hysterectomy was performed via the abdominal route in 17.39% of cases and vaginal route in 6.96%. The postoperative course was simple in 75.65% of cases and complicated in 24.35%. Complications were dominated by anaemia (13.04). The average length of stay was 6.05 days with extremes of 3 and 13 days.
Conclusion: The frequency of the uterine fibromyomas is raised in the region of Labé and the hold in charge is often surgical. |
| Cystectomy of Ovarian Borderline and Malignant Tumors for Fertility Sparing: Outcome of Seventeen Cases | Author : Junko Wroblewski | Abstract | Full Text | Abstract :Background: Here we present a retrospective study of 17 cases in which the ovary on the affected side was spared in fertility-sparing surgery (FSS) during treatment for ovarian borderline malignant or malignant tumor. We determine that cystectomy is a suitable treatment for ovarian borderline tumors.
Methods: A retrospective observation study was conducted at Saiseikai Fukuoka General Hospital in Japan between April 2009 and September 2020. Our hospital experienced 89 cases of FSS during treatment for ovarian borderline or malignant tumor. Of those, there were 17 cases in which the ovary on the affected side was spared. We examined recurrent and pregnant cases by stage, preoperative diagnosis, intraoperative pathological diagnosis, postoperative pathological diagnosis, and adjuvant therapy.
Result: Of the 17, 12 cases were borderline malignant tumor, 4 were immature teratoma grade 1 (G1), and 1 case was endometrioid adenocarcinoma G1. Rapid intraoperative pathological diagnosis was conducted in 9 of the cases, and there were 6 in which surgical method was chosen based on the aforementioned results. Laparoscopic surgery was performed in 2 cases in which tumors were deemed benign via preoperative diagnosis, 2 cases of mature teratoma, and 2 in which borderline ovarian tumor was suspected. One (1) case of paraovarian cystecomy in a patient with history of multiple cesarean sections turned out to be serous borderline tumor. Postoperative treatment took place in only 1 case: endometrioid adenocarcinoma. There were 2 cases of recurrence, and 4 cases were eventually able to become pregnant naturally post-surgery. These pregnant cases included 1 in which serous borderline tumor recurred and we performed both cystectomy and lymphadenectomy, and one in which chemotherapy was performed after cyst enucleation for endometrioid adenocarcinoma G1.
Conclusion: At present, there is no clear policy for FSS in cases such as stage Ib in which there are bilateral tumors. Accordingly, in the current study a radiologist was consulted for preoperative diagnosis, and surgical method was chosen with a view towards possible borderline malignancy or malignancy. In cases where fertility preservation of the affected ovary is a high priority, it is crucial to clearly explain the possibility of recurrence to the patient. We also stress the importance of detailed consultation among the surgical team during rapid intraoperal frozen section pathological examination for making the appropriate decision to ensure fertility preservation mid-surgery. |
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