ABSTRACT
PURPOSE: The study aim was to report diagnostic and therapeutic challenges in treatment of a patient with cervical dysplasia and con- genital uterine anomaly. CASE REPORT: A 53-year-old women with Müllerian anomaly - uterus duplex (bicorporal septate uterus) and Y-shaped endocervical canal was referred due to repeated abnormal Pap smears. She underwent endocervical curettage of both canals and the endocervical septum biopsy which revealed presence of cervical intraepithelial neoplasia (CIN) III. Cervical conization was considered technically unfeasible because of abnormal cervical anatomy (lesions deep in the cervical canal on the cervical bifurcation where the cervical wall is the thickest). Classical open abdominal hysterectomy was performed. Patient had two almost equally-sized, symmetrical uterine bodies connected in the isthmico-cervical region, with normal left and obstructed right hemi-vagina. Postoperative histopathological findings confirmed that dysplasia was located in the region where two endocervical canals conjoined. CONCLUSION: Diagnostic and therapeutic approach to patients with uterine anomalies has to be individualized, based on anomaly type, patient's age, reproductive history, and patient's preferences.
Subject(s)
Mullerian Ducts/abnormalities , Uterine Cervical Dysplasia/therapy , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Uterine Cervical Dysplasia/diagnostic imaging , Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/therapyABSTRACT
PURPOSE: The study aim was to report an unusual case of a misplaced IUD in isthmico-cervical region causing partial uterine perforation and discuss literature data regarding such a condition. CASE REPORT: A 50-year-old women was referred to the present institution for IUD extraction. She was diagnosed with spontaneously misplaced IUD located in isthmico-cervical region of the uterus causing partial perforation. The time of dislocation was unknown, as she was completely asymptomatic for ten years after IUD application. More-over, she had no risk factors for device misplacement. The removal of IUD was uneventful. CONCLUSION: Isthmico-cervical misplacement of IUD, although rare, can occur at any time and can be asymptomatic. Thus, women with IUD should be annually checked-up in order to prevent possible IUD complications.
Subject(s)
Intrauterine Devices/adverse effects , Uterine Perforation/etiology , Asymptomatic Diseases , Female , Humans , Middle Aged , Risk FactorsABSTRACT
This study investigated maternal hemodynamic influence on uteroplacental oxygen distribution and neonatal outcome during cesarean section (CS). CS was performed on 80 parturients using two anaesthetic techniques: spinal anaesthesia (SA) and general balanced anaesthesia (GBA). Indications for CS were exclusively obstetric related. Monitored maternal parameters were: ECG, heart rate (HR), non-invasive blood pressure (NIBP), saturation (SaO2). Gas parameters in umbilical artery, vein, and neonatal capillary blood were sampled. Vitality was assessed by the Apgar scoring, first breath-taking time and the first breastfeeding attempt. Hypotension was the most common finding after SA induction. GBA group presented changes such as QT inversion (12.5%), tachycardia (55%), and bradycardia (2.5%). SA group experienced higher rates of sinus tachycardia (45%) and ventricular dysrhythmias (2.5%). Neonatal oxygenation was significantly higher in SA group. Higher quality of early neonatal adaptation in the SA group confirms it as the technique with the least neonatal risk during CS.
Subject(s)
Anesthesia, General , Anesthesia, Spinal , Cesarean Section , Oxygen/metabolism , Placenta/metabolism , Umbilical Cord/metabolism , Uterus/metabolism , Adult , Apgar Score , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Young AdultABSTRACT
Analyses were carried out on 545 Wertheim-Meigs radical hysterectomies performed at the Institute of Gynecology and Obstetrics of the Clinical Center of Serbia during a four-year period from 2002 to 2006. More than ten lymphatic glands in 84.4% of patients were removed. The apical part of the vagina was removed in 77.8% of cases, and 77.6% of patients had the right part of the vagina removed. Distribution of surgical radicality according to FIGO stage of disease has been demonstrated. Comparison of research results in the period from 1996 to 2000 shows a significantly more radical approach concerning the number of lymphatic glands removed during this period.
Subject(s)
Uterine Cervical Neoplasms/surgery , Fallopian Tubes/surgery , Female , Humans , Hysterectomy , Lymph Node Excision , Ovariectomy , Pelvic Bones , Uterine Cervical Neoplasms/pathology , Vagina/surgeryABSTRACT
The peak incidence of immature teratoma is in the early reproductive period of a woman's life and fertility preservation is an inevitable topic when discussing treatment options. We present two cases of immature teratoma with positive reproductive outcome. Our experience supports the standpoint that surgery alone is curative in most cases, irrespective of tumor grade. Bearing this in mind, the long-term effect of chemotherapy on ovarian function can be avoided and fertility, an important factor in the overall quality of life, can be preserved.