RESUMO
Embryonal rhabdomyosarcoma (sarcoma botyroides) of the cervix, which is rare, is described in a 16-year-old. The combined use of chemotherapy, radiotherapy and surgery has markedly improved survival in those with this condition. However, our patient did not benefit from this treatment modality due to late presentation and loss to follow-up.
Assuntos
Rabdomiossarcoma Embrionário/patologia , Neoplasias do Colo do Útero/patologia , Adolescente , Antibacterianos/uso terapêutico , Transfusão de Sangue , Feminino , Humanos , Perda de Seguimento , Pseudomonas/isolamento & purificação , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/tratamento farmacológico , Rabdomiossarcoma Embrionário/cirurgia , Resultado do Tratamento , Neoplasias do Colo do Útero/cirurgia , Hemorragia Uterina/etiologiaRESUMO
BACKGROUND: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine rupture and post partum haemorrhage (PPH) have been documented. METHOD: This is to report a case of disseminated intravascular coagulopathy (DIC) associated with use of misoprostol for induction of labour and to call for extra vigilance in its use. RESULT: This was a case of 22-year old gravida 2 para 1 at 42 weeks gestation that was induced with 100 microg of misoprostol and delivered a live female baby with good Apgar score. She subsequently developed PPH and epistaxis simultaneously, then conjunctival haemorrhage 30 minutes later. She was managed with fresh whole blood and had a satisfactory recovery. CONCLUSION: Life threatening complication could result from use of Misoprostol. More research and high index of suspicion are needed to establish the association of prostaglandins with DIC.
Assuntos
Coagulação Intravascular Disseminada/etiologia , Trabalho de Parto Induzido/efeitos adversos , Adulto , Coagulação Intravascular Disseminada/complicações , Hemorragia Ocular/etiologia , Feminino , Humanos , Misoprostol , Ocitócicos , Hemorragia Pós-Parto/etiologiaRESUMO
BACKGROUND: Eclampsia has now emerged as one of the commonest cause of maternal mortality in Nigeria. There is need for research on best modality for delivery of eclamptics. METHODOLOGY: The pilot study was conducted on 50 eclamptic patients at the Federal Medical Centre, Azare. The patients were randomized for delivery either by caesarean section (CS) or induction of labour. The fetomaternal outcome of the two groups was compared. RESULTS: 25 of the patients had CS and 25 had induction of labour with misoprostol. The mean decision delivery interval was 4.1 hours and 13.08 hours for the CS and misoprostol groups respectively. Misoprostol failure was recorded in 4 (16%) patients and they were subsequently delivered by CS. The duration of admission was longer in the CS group (mean of 10.1 days) compared to the misoprostol group (mean of 6.08 days). There were more maternal complications and admissions of babies into the SCBU in the CS group. Maternal mortality in the two groups was similar (2% each). CONCLUSION: Misoprostol is cheap, available and safe for delivery of antepartum eclamptics. In the event of delay at caesarean section for antepartum eclamptics patients, misoprostol induction should be started. A multicenter study is called for.