RESUMO
Actinomycosis is an infection due to an anaerobic Gram-positive bacilus bacteria: Actinomyces. Tubo-ovarian locallisation is rare. It more often appears clinically as a pseudo-tumoral and feverish syndrom, evoking wrongly a malignant tumoral pathology, and often leads to a mutilating surgical treatment. Intra-uterine device appears as the principal favorable factor of this pathology. Basing on two cases reported by the authors, and after literature review, physiopathology, clinical and paraclinical expression, and treatment of this affection are discussed. A set up is made.
Assuntos
Actinomicose , Doenças das Tubas Uterinas , Dispositivos Intrauterinos/efeitos adversos , Doenças Ovarianas , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Actinomicose/etiologia , Actinomicose/cirurgia , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Doenças das Tubas Uterinas/diagnóstico , Doenças das Tubas Uterinas/etiologia , Doenças das Tubas Uterinas/cirurgia , Feminino , Seguimentos , Humanos , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/etiologia , Doenças Ovarianas/cirurgia , Penicilina G/administração & dosagem , Penicilina G/uso terapêutico , Fatores de TempoRESUMO
The purpose of this study is to determine predictive factors of successful vaginal delivery after cesarean section, and to estimate the risks of this trial of labor (TOL). A retrospective study about 352 women undergoing a TOL after cesarean section was carried out. Different variables stratified by the termination of the TOL were analysed with statistic tests. TOL success rate was 76.1%. Parity > or = 3. prior vaginal delivery following cesarean section, body mass index < 30, fundal height < 34 cm, and low fetal head level at the beginning of labor increased significantly the probability of success. Uterine rupture rate is 1.1%. Failure of TOL was associated with a higher risk of uterine scar dehiscence and rupture, and higher fetal morbidity. A predictive score of successful vaginal delivery after cesarean section is proposed.