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1.
Cureus ; 16(3): e56753, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38654788

RESUMO

This comprehensive review provides an in-depth examination of congenital anomalies of the female genital tract, explicitly focusing on the American Society for Reproductive Medicine (ASRM) Müllerian Anomalies Classification. The classification system is crucial for standardizing communication and guiding accurate diagnoses in clinical practice. The review explores the diverse clinical presentations, etiological factors, and diagnostic modalities associated with these anomalies. Management strategies, ranging from conservative approaches to advanced reproductive technologies, are discussed in the context of individualized treatment plans based on the ASRM classification. The psychosocial impact of female genital tract anomalies is thoroughly examined, emphasizing the importance of holistic care and patient-centered approaches. Looking toward the future, the review outlines emerging research areas, including advances in diagnosis techniques, innovative treatment modalities, and genetic studies. It ultimately underscores the need for a comprehensive understanding of physical and psychosocial dimensions, offering insights for healthcare professionals to navigate this complex landscape and improve the lives of affected individuals.

2.
Cureus ; 16(2): e53618, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38449926

RESUMO

This comprehensive review explores the practice of fetal reduction through potassium chloride infusion in unruptured heterotopic pregnancies. Heterotopic pregnancies, characterized by the simultaneous occurrence of intrauterine and extrauterine gestations, present unique challenges in reproductive medicine. The review defines fetal reduction and underscores its significance in mitigating risks associated with heterotopic pregnancies, including the threat of rupture, maternal morbidity, and adverse outcomes. The analysis encompasses the background, methods, efficacy, ethical considerations, and future directions related to the procedure. Findings highlight the efficacy and safety of potassium chloride infusion, emphasizing the importance of proper patient selection and counseling. Implications for clinical practice underscore the procedure's viability in specific cases where the benefits outweigh the associated risks. The review concludes with recommendations for future studies, encouraging further research on procedural techniques, alternative methods, and the psychosocial impact on patients. This work is a foundation for advancing the management of unruptured heterotopic pregnancies, providing insights for clinicians and researchers to improve clinical outcomes and patient care.

3.
Cureus ; 16(2): e53700, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38455810

RESUMO

Mature teratomas, also known as ovarian dermoid cysts, are benign embryonal tumors that develop slowly. One of the following imaging techniques is commonly employed to evaluate these cysts: transvaginal ultrasound, pelvic ultrasonography, magnetic resonance imaging, or computed tomography. The two surgical methods most frequently used for removing persistent or very large cysts are laparoscopy and laparotomy. A 42-year-old female, who is P3L1D2 with a history of previous cesarean section, presented with an abdominal mass that had been gradually increasing in size over the past five months. She also reported lower abdominal pain for the last five days. Upon further evaluation, she was diagnosed with a left ovarian dermoid cyst. The patient underwent exploratory laparotomy, during which a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The cut section of the gross cyst specimen revealed abundant sebaceous fluid and a large tuft of hair, which was confirmed by histopathology. The patient was followed up every three months for a year. Ovarian tumors typically manifest with nonspecific symptoms. The early recognition of dermoid cysts and prompt intervention are crucial to prevent potential complications.

4.
Cureus ; 16(1): e51534, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38304637

RESUMO

The cytomegalovirus (CMV), a common DNA virus with a high global seroprevalence, is the primary cause of teratogenic congenital infections, which presents a serious risk to public health. Maternal CMV infection is linked to congenital CMV (cCMV), a major contributor to non-genetic sensorineural hearing loss, cognitive developmental impairments, and cerebral palsy in infants. Transmission might occur through direct contact with infected bodily fluids, with higher transmission rates after primary infection and an increased risk of severe fetal effects before 20 weeks. The mother and fetus do not get immunity from a prior infection. Fetal growth restriction, fetal loss, and cerebral or extra-cerebral abnormalities that can be detected by ultrasonography are possible presentations of cCMV. Specific antibody detection or seroconversion is required for the diagnosis of maternal CMV during pregnancy. Amniocentesis is used to diagnose fetal CMV during pregnancy after eight weeks of presumed maternal infection and 17 weeks of gestation. The main preventive measure is hygiene education, as the effectiveness of immunoglobulins, antiviral medications, and vaccines is still up for debate. The focus is particularly directed toward the anomalous fetal outcomes observed during the course of the pregnancy.

5.
Cureus ; 15(10): e46832, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37954760

RESUMO

Placental abruption, a rare but life-threatening obstetric emergency, presents substantial risks to maternal and fetal well-being. This case report documents the clinical journey of a 35-year-old woman with multiple risk factors who presented at 30 weeks gestation with symptoms suggestive of placental abruption, including colicky lower abdominal pain and vaginal bleeding. Notably, her late initiation of prenatal care and a history of pregnancy-induced hypertension added complexity to the clinical picture. The case revealed a Couvelaire uterus, an uncommon and challenging complication of placental abruption, further emphasizing the need for early recognition and swift intervention. A multidisciplinary approach played a pivotal role in managing this high-risk obstetric case. Imaging and laboratory tests facilitated diagnosis and assessment, guiding surgical intervention and post-operative care. Despite the severity of the condition, the patient experienced a positive outcome for herself and her fetus, highlighting the critical importance of timely and comprehensive medical care. This case report contributes to medical knowledge by shedding light on the rare Couvelaire uterus. It underscores the significance of early diagnosis, coordinated healthcare teams, and patient education in mitigating risks associated with placental abruption. Ultimately, it reinforces the vital role of healthcare providers in safeguarding the lives of expectant mothers and their infants in obstetric emergencies.

6.
Cureus ; 15(8): e44005, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37746402

RESUMO

Retained intrauterine fetal bone fragments are emerging as a potential yet often overlooked cause of secondary infertility, posing significant challenges for couples who have previously experienced successful pregnancies. This review article explores the association between retained fetal bone fragments and secondary infertility by delving into their impact on fertility, pregnancy outcomes, and diagnostic challenges. The review highlights the underlying mechanisms of fragment retention, including immune response and inflammation, and their detrimental effects on endometrial receptivity and implantation. The diagnostic difficulties and importance of specialized imaging techniques like hysteroscopy for accurate diagnosis are also discussed. The article also provides insights into available treatment options, such as medical management and surgical interventions, focusing on hysteroscopy as the gold standard for diagnosis and treatment. The implications for clinical practice emphasize early diagnosis and intervention to improve fertility outcomes and reduce the emotional burden of secondary infertility. Furthermore, the review discusses preventive strategies and the potential for future research to refine diagnostic methods and explore novel treatments. By recognizing and addressing the impact of retained fetal bone fragments, this review aims to enhance the understanding and management of this condition, providing valuable support to couples seeking to overcome the challenges of secondary infertility on their journey toward parenthood.

7.
Cureus ; 15(11): e49752, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38161931

RESUMO

This review comprehensively examines the current state and future directions of gynecological surgery, focusing on the comparative analysis of laparoscopy and robotic surgery. The overview highlights the evolution of these surgical techniques, emphasizing their impact on patient outcomes, procedural efficiency, and safety profiles. The analysis encompasses critical factors such as cost-effectiveness, learning curves, and implications for postoperative recovery. The future of gynecological surgery is envisioned through emerging technologies, including augmented reality, single-incision laparoscopy, and artificial intelligence. The coexistence of laparoscopy and robotics is explored, acknowledging their respective strengths and roles in shaping women's healthcare. In conclusion, the dynamic nature of the field is underscored, emphasizing the need for a patient-centered and adaptable approach. Collaboration between healthcare professionals, engineers, and researchers is pivotal in unlocking these innovations' full potential, ensuring continued advancements in gynecological surgery for improved outcomes and enhanced patient care.

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