Surgical Management of Multiple Hydatid Cysts in Second Trimester Pregnancy.

Although hydatid cysts are an endemic infestation, experience in surgical management of pregnant women is quite limited. This report aims to share the results and experiences gained from the management and surgery of a woman with a second trimester pregnancy who presented with asphyxia because of the rupture of a giant bilateral hydatid cyst.

Comparison of tissue trauma after abdominal, vaginal and total laparoscopic hysterectomy.

OBJECTIVE: The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. MATERIAL AND METHODS: Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively and 2, 6 and 24 h after surgery. RESULTS: Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.00 1). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital stay CONCLUSIONS: AH causes more tissue trauma as compared to VH and TLH. Owing to the fact that TLH is associated with less tissue trauma and offers significant clinical benefits, including less blood loss and shorter hospital stay it should be considered in women with benign gynecologic conditions, especially in experienced centers.

Sociodemographic and clinical features of postpartum depression among Turkish women: a prospective study.

BACKGROUND: Postpartum depression (PPD) is moderate to severe depression in a woman after she has given birth. Findings from several well-designed studies reflect great variability in rates, from 10 to 22%, and also in risk factors for PPD. This variability may reflect geographical location. The incidence and risk factors for PPD among Turkish women are not well documented. It is, however, important to understand the risk factors to develop preventive intervention strategies. This study aims to examine the prevalence of PPD and associated risk factors among a sample of women receiving services at a tertiary obstetrics hospital in Ankara, Turkey. METHODS: A sample of 671 women, between 36 and 40 gestational weeks, were enrolled and screened for depressive symptomatology using the Hospital Depression Inventory. Sociodemographic and clinical data were also collected. At a subsequent postpartum evaluation, 6-8 weeks post-delivery, 540 of the 671 were screened using the Edinburgh Postnatal Depression Scale (EPDS) for PPD. RESULTS: Eighty-three (15.4%) of the 540 women had scores above the cutoff point (>13) on the EPDS. Statistically significant correlations were found between antenatal, prenatal and postpartum depression scores (r = 0.24). Women reporting suicidal thoughts during pregnancy (OR: 6.99), history of past PPD (OR: 6.64), physical violence during pregnancy (OR: 6.20) or during the postpartum period (OR: 5.87), previous psychiatric history (OR: 4.16), depressive symptoms during pregnancy (OR: 1.70), subjectively lower level of satisfaction with the pregnancy (OR:0. 69), a history of premenstrual syndrome (PMS) (OR: 2.05), and unplanned pregnancy (OR: 1.69) had higher odds for developing PPD. CONCLUSION: One in six mothers screened as positive for PPD. Women who had previously been diagnosed with PPD, reported suicidal thoughts during pregnancy, or had been exposed to physical violence were at especially high risk for postpartum depression. To prevent and treat postpartum depression, special attention should be paid to women reporting these characteristics.

Diagnosis of pentalogy of cantrell in the first trimester using transvaginal sonography and color Doppler.

We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy.

Diagnosis and management of female adnexal tumor of probable Wolffian origin (FATWO) arising from ovary: a case report.

Female adnexal tumor of probable Wolffian origin (FATWO) is a rare neoplasm which is usually considered as benign, although in some cases metastasis or recurrences have been reported even after a long interval following the initial diagnosis. Preoperative diagnosis of FATWO is very difficult because of the rarity of the disease and the limited literature available. In this case report, we present a case of FATWO arising from the ovary and review the literature based on the clinical characteristics and management of this rare condition. A 51- year- old postmenopausal woman was referred to our clinic for evaluation of an adnexal mass. After diagnostic evaluation, the patient underwent explorative laparotomy. Intra-operatively, a solid- cystic mass was found in the right ovary, the rest of the abdomen and the pelvis were normal. The ovarian mass was removed and examined with frozen-section (FS). When the frozen section proved negative for malignancy, total abdominal hysterectomy and bilateral adnexectomy were performed. The anatomic study revealed a well-capsulated mass which was 3.5×1.5 cm in diameter. Based on pathological and immunohistochemical results, the final diagnosis was concluded to be FATWO. Adjuvant therapy was not administered. Te patient was followed up after discharge from the hospital. One year after surgery she was asymptomatic. No evidences of recurrence were observed throughout this period. Although FATWOs are rare tumors, they should be kept in mind in women with an abdominal mass. They can present diagnostic difficulties and the diagnosis is based on the exclusion of other neoplasms. FATWO has malignant potential, after the initial surgical treatment patients should be appropriately followed up for possible recurrence and metastasis.