Vulvar intraepithelial neoplasia in a young woman with systemic lupus erythematosus: a case report.

Diagnosing vulvar intraepithelial neoplasia in a young woman presenting mainly with skin manifestations of lupus and with no other risk factors is a major challenge. The case of a 27-year-old woman with systemic lupus erythematosus and vulvar intraepithelial neoplasia is described. Although progression of vulvar intraepithelial neoplasia to invasive planocellular carcinoma is rare, prompt and adequate diagnosis and treatment will help ensure the best possible quality of life.

Pregnancy following the laparoscopic bipolar electrocoagulation of polycystic ovaries resistant to medicamentous ovulation induction--a case report.

The case of a primarily infertile patient with polycystic ovaries (PCOS) resistant to medicamentous ovulation induction is presented. The preoperative condition, laparoscopic ovarian drilling using an original technique of bipolar electrocoagulation and consecutive spontaneous pregnancy and delivery are described. This case suggests that bipolar forceps with jaws 1 mm wide could be a useful instrument for laparoscopic ovarian drilling.

Laparoscopic management of the cornual pregnancy.

Traditional treatment of interstitial pregnancy includes cornual resection or hysterectomy by laparotomy, but advanced minimally invasive surgery allows successful endoscopic management. We report a case where interstitial pregnancy was successfully diagnosed by ultrasound and treated by laparoscopy. Patient had an unremarkable postoperative course. This case demonstrates that a laparoscopic approach toward cornual pregnancy is possible.

[Pregnancy outcome after early amniocentesis]. / Ishod trudnoce nakon rane amniocenteze.

The indications, karyotype, and outcome of 1812 pregnancies following midtrimester amniocentesis (eACZ/as) performed from 1977 to 1989 are presented, especially regarding the risk of pathologic karyotypes and spontaneous abortion. There were 37 pathologic karyotypes (trisomy 21 in 24 pregnancies). The spontaneous abortion rate following amniocentesis was 2.8% although it was almost halved after direct ultrasound guidance had been introduced (1.87% versus 3.66%). In gravidas with previous spontaneous abortion, the preterm delivery rate and spontaneous abortion rates following rACZ were significantly increased. There is a progressive increase of the spontaneous abortion rate after eACZ with the number of previous spontaneous abortions; 5.83% when there was only 1 previous spontaneous abortion, 7.83% when there were 2, and 8.75% when there were 3 or more spontaneous abortions. Previous spontaneous abortions do not increase the risk of chromosomal aberration. In women aged 37 years or more the risk of trisomy 21 is 0.69%, aged 38 years 1.55% and over 39 years 0.44%. The risk is rapidly increasing after 40 years of age (2.25%). The proportion of pathologic karyotypes in these age groups was significantly higher in comparison to younger women. The age limit of 37-38 years as the indication of a possible appearance of mid-trimester ACZ is discussed.