Retraction: Pure Uterine Lipoma: A Report of a Rare Entity.

[This retracts the article DOI: 10.7759/cureus.20444.].

Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women.

The objective of the study was to analyse and compare demographic characteristics and clinical outcomes of pregnancies in adolescent, advanced age and normal reproductive age women. All completed pregnancies in a 6-month period, registered by the family practitioners in Denizli province, were included into the study. A face-to-face questionnaire was used to gather information. Participants were asked for demographic information, pregnancy outcome and obstetric history, obstetric and neonatal problems. Overall 5,882 pregnancies in different age groups: 296 (5%) adolescent (< 20-years-old); 4,957 (84.3%) normal reproductive age (20-35-years-old) and 629 (10.7%) advanced age (> 35-years-old ) (group III), were included into the study. Adolescent women had a lower educational status (p < 0.01), and family played a major role in decision of marriage (p < 0.01). Birth weight of the baby was lower in adolescents (p < 0.01). While adolescents tended to deliver vaginally (OR = 1.9, p < 0.01), elderly women were more prone to operative delivery (OR = 1.2, p < 0.05). Risk of caesarean section rate was higher in elderly nulliparous women (OR = 2.2, p 0.01). The number of spontaneous and induced abortions were increased with age (p < 0.01). Antenatal problems were seen least frequently in normal reproductive age women. Both antenatal (OR = 1.7, p < 0.01) and neonatal problems (OR = 1.5, p < 0.05), were significantly higher in advanced age pregnancy. It was concluded that with sufficient antenatal care, adolescent pregnancy is not associated with an increase in adverse pregnancy outcome, except low birth weights. Advanced maternal age is more likely to be associated with increased obstetric, maternal and neonatal complications.

Pure Uterine Lipoma: A Report of a Rare Entity.

Abnormal genital tract bleeding is a commonly encountered complaint in general practice. It has a wide range of etiologies and the spectrum depends on the reproductive status of the patient. While it represents a small proportion of genital tract bleeding, endometrial carcinoma is the main concern in postmenopausal women with abnormal genital bleeding. However, the majority of cases are due to benign etiologies. We present the case of a 65-year-old woman who presented to the outpatient department complaining of vaginal bleeding and lower abdominal pain for the last two months. The patient did not report any use of hormonal replacement therapy. Her last Pap smear was five years ago and it yielded no abnormal cells. On examination, the patient appeared obese with a body mass index of 35 kg/m2. Abdominal examination revealed a palpable pelvic mass that was firm and non-tender. The patient underwent an abdominal computed tomography scan which demonstrated a well-defined oval-shaped homogeneous fat attenuation mass lesion within the uterine wall with no evidence of invasion. Such findings were suggestive of uterine lipoma. The patient underwent a total hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination of the specimen confirmed the diagnosis of pure lipoma. After six months of close follow-up, the patient had no active complaints. Pure uterine lipoma is an exceedingly rare benign neoplasm of the uterus. It may present with an abdominal mass and abnormal genital bleeding. Awareness of the clinical and radiological features of this tumor is crucial to avoid unnecessary surgeries in asymptomatic patients.

Suppression of cortisol by a progestational steroid, melengestrol.

Melengestrol, a steroid with progestational activity but with a structure that does not resemble that of cortisol, suppresses plasma cortisol in humans with a potency 1/40th that of dexamethasone. The 6alpha-methyl and 17alpha-acetoxy substituents and the 6,7 double bond of melengestrol acetate are known to slow the metabolism of similar steroids. Insertion of a 6alpha-methyl group markedly increases the glucocorticoid activity of 17alpha-OH-progesterone. The glucocorticoid activity of melengestrol is presumably attributable to the large dose administered in our study, its slow metabolism and limitations of the specificity of glucocorticoid tissue receptors.