Hysteroscopic management of lower genital tract lesions in females with limited vaginal access.

OBJECTIVE: To show that hysteroscopy is a feasible and safe method of evaluation in females with limited vaginal access. DESIGN: Retrospective review of two patients who received hysteroscopy for evaluation of uterus didelphys with hemivagina and a cervical polyp. SETTING: Private hospital. PATIENT(S): Two patients with either a vagina septum or cervical polyp. INTERVENTION(S): Hysteroscopy for visualization and resection. MAIN OUTCOME MEASURE(S): Resection of a vagina septum and cervical polyp. RESULT(S): No more cyclic dysmenorrhea in the patient with uterus didelphys and cessation of abnormal bleeding in the patient with a cervical polyp. Our results suggest that hysteroscopy can provide precise visualization of vagina and cervical lesions if the approach is difficult with decreased access, and allows concurrent treatment of pathologic conditions accordingly. CONCLUSION(S): Hysteroscopy is favorable in the diagnosis and treatment of vaginal and cervical lesions in women with limited vaginal access because of age or a narrower vagina. In the Eastern culture, it is very important for females to maintain their state of virginity signified by an uninjured hymen ring. This problem is solved, as hysteroscopy allows the evaluation of malformations of the female genital tract.

Topical vaginal oestrogen cream used for treatment of burn injury of vaginal mucosa after misapplication of 100% acetic acid in a perimenopausal woman: a case report.

BACKGROUND: Three to five per cent acetic acid is commonly used in the field of gynaecology for colposcopic examinations of the cervix. It gives an 'acetowhite' effect that may assist clinicians in identifying neoplastic areas. CASE: A perimenopausal woman was treated with acetic acid for abnormal Pap smear report (cervical intraepithelial neoplasia 1). During application, the patient complained of burning sensation of vagina and vulva. The vagina was saline-irrigated after realising that the acetic acid had not been diluted. Following this incident, the patient was seen weekly and treated with conjugated vaginal oestrogen cream. The patient recovered and the vagina mucosa healed within two weeks. CONCLUSION: Acetic acid is corrosive and may cause vagina bleeding. Oestrogen cream can be used in an attempt to minimise the adverse reaction and speed the healing process.

Volvulus in pregnancy: a diagnostic dilemma.

In this case report, we describe a pregnant female patient at 27 weeks' gestation with a rare complication of volvulus. Her initial symptom was acute cramping pain of the lower right abdomen. Surgical intervention was performed under the impression of peritonitis. Pathologic diagnosis revealed volvulus of the mid ileum. The remainder of her pregnancy was uneventful. The physiologic changes of pregnancy may predispose the parturient to bowel obstruction due to compression of the gravid uterus against the intestine. If volvulus is suspected, then emergent surgery should be performed. Delays in treatment may result in septic shock and even death. We present this case to remind obstetricians of such rare causes of acute abdomen during pregnancy.

Choosing calcium channel blockers for pregnant women with paroxysmal supraventriclar tachycardia and preterm labor: a case report.

Preterm labor is a major clinical hazard causing both maternal and neonatal morbidity and mortality. Paroxysmal supraventricular tachycardia (PSVT) complicated by preterm labor is rare. Of the many drugs used to treat PSVT, only calcium channel blockers are tocolytics. Here, we present the case of a 29-year-old female admitted to our ward with previously diagnosed PSVT and preterm labor at 31 weeks' gestation of her fourth pregnancy. Calcium channel blockers were administered and her uterine contractions subsided. Afterwards, no side effects were noted and she suffered no further tachycardic attacks during her pregnancy. She successfully delivered a full-term baby and received subsequent regular follow-up at the outpatient clinic.