Incidental Endometrial Adenocarcinoma in Early Pregnancy: A Case Report and Review of the Literature

2009 ◽  
Vol 19 (9) ◽  
pp. 1580-1584 ◽  
Author(s):  
Hannuna Karen Yael ◽  
Putignani Lorenza ◽  
Silvestri Evelina ◽  
Pisa Roberto ◽  
Angioli Roberto ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Conservative Therapy ◽  
Endometrial Adenocarcinoma ◽  
First Trimester ◽  
Dilatation And Curettage ◽  
Gynecology And Obstetrics ◽  
Stage Ia

Endometrial cancer is the most common neoplasia of the female reproductive system, with the highest incidence among uterine malignancies, and is rarely associated with pregnancy. Thirty-five cases of pregnancy-associated endometrial cancer have been reported in literature, of which ours represents the 20th case diagnosed during the first trimester. A 39-year-old woman, gravida 4, para 2, was diagnosed with a focal, well- to moderately differentiated endometrial adenocarcinoma (International Federation of Gynecology and Obstetrics stage IA and grades G1 and G2) after dilatation and curettage (D&C) for a spontaneous abortion. The patient underwent progestational therapy and follow-up hysteroscopies and D&C to preserve fertility; she is alive and well 18 months after diagnosis. Recurrence of endometrial cancer coexisting with early pregnancy has not been reported in the literature. Conservative therapy for early endometrial cancer, diagnosed at the time of pregnancy, may be an option. Routine histologic examination after D&C performed for spontaneous abortion seems advisable.

Combined Oral Medroxyprogesterone/Levonorgestrel-Intrauterine System Treatment for Women With Grade 2 Stage IA Endometrial Cancer

2017 ◽  
Vol 27 (4) ◽  
pp. 738-742 ◽  
Author(s):  
Ji Young Hwang ◽  
Da Hee Kim ◽  
Hyo Sook Bae ◽  
Mi-La Kim ◽  
Yong Wook Jung ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Progressive Disease ◽  
Medical Center ◽  
Endometrial Adenocarcinoma ◽  
Complete Response ◽  
Dilatation And Curettage ◽  
Fertility Sparing ◽  
Stage Ia ◽  
The Mean

ObjectiveThe aim of this study was to evaluate the oncologic and pregnancy outcomes of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with grade 2–differentiated stage IA endometrial adenocarcinoma who wish to preserve fertility.MethodsWe retrospectively reviewed the medical records of patients with grade 2 stage IA endometrial adenocarcinoma who had received fertility-sparing treatment at CHA Gangnam Medical Center between 2011 and 2015. All of the patients were treated with combined oral MPA (500 mg/d)/LNG-IUS, and follow-up dilatation and curettage were performed every 3 months.ResultsA total of 5 patients were included in the study. The mean age was 30.4 ± 5.3 years (range, 25–39 years). After a mean treatment duration of 11.0 ± 6.2 months (range, 6–18 months), complete response (CR) was shown in 3 of the 5 patients, with partial response (PR) in the other 2 patients. One case of recurrence was reported 14 months after achieving CR. This patient was treated again with combined oral MPA/LNG-IUS and achieved CR by 6 months. The average follow-up period was 44.4 ± 26.2 months (range, 12–71 months). There were no cases of progressive disease. No treatment-related complications arose.ConclusionsCombined oral MPA/LNG-IUS treatment is considered to be a reasonably effective fertility-sparing treatment of grade 2 stage IA endometrial cancer. Although our results are encouraging, it is preliminary and should be considered with experienced oncologists in well-defined protocol and with close follow-up.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Thyroid dysfunction among Indian pregnant women and its effect on the maternal and fetal outcome

2021 ◽  
Vol 10 (3) ◽  
pp. 893
Author(s):  
Aditi Jain ◽  
Raksha M. ◽  
Kanakalatha D. Nakum
Keyword(s):  
Early Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder

Background: Screening of thyroid disorders in antenatal women during first trimester, to recommend management of thyroid disorder during pregnancy and to know the maternal and fetal outcome of such pregnancy.Methods: This is a prospective study for the incidence of thyroid disorder in early pregnancy and the outcome of such pregnancy. 100 cases were randomly selected from the antenatal clinic at a tertiary care hospital in India and after fulfilling the inclusion criteria they were subjected to screening for thyroid disorder till 13 weeks of pregnancy. TSH is often considered the “gold standard” for assessing thyroid function. If the participant had normal value then she was not subjected to follow up, but if abnormal, then follow up was done after 4-8 weeks, thyroid profile was repeated and if values were altered, they were medically managed and closely monitored. The obstetric and perinatal outcome of the pregnancy was noted.Results: In this screening study to detect and manage thyroid disorder, 100 antenatal women were selected randomly, from which 49 women where primigravidae and 51 women were multi-gravidae, 17 of them were of <20years, 54 were between 21 to 25 years. There was 5 percent incidence of thyroid disorder in the study group. There were 3 cases of hyperthyroidism and 2 cases of overt hypothyroidism which had poor fetal and maternal outcome on follow up.Conclusions: Our study shows that the evaluation of thyroid disorders in early pregnancy and timely intervention will lead to a decrease in the complications thereby improving the maternal and fetal outcome.

First Trimester Hemoglobin A1 and Risk for Major Malformation and Spontaneous Abortion

2021 ◽  
pp. 13-19
Author(s):  
Rachel Blake ◽  
Chloe Zera
Keyword(s):  
Spontaneous Abortion ◽  
Clinical Case ◽  
First Trimester ◽  
Spontaneous Abortions ◽  
Major Malformation ◽  
Fetal Malformations ◽  
Study Population ◽  
Hemoglobin A1 ◽  
Location Study

This chapter summarizes a landmark study on the association of first trimester hemoglobin A1 values with risk for spontaneous abortions and major fetal malformations during pregnancy in women with pregestational diabetes. Is there a correlation between glycemic control during the first trimester and risk for spontaneous abortion and major malformations? Starting with this question, it describes the basics of the study, including study location, study population, amount of patients, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Efficacy of Megestrol Acetate (Megace) in the Treatment of Patients With Early Endometrial Adenocarcinoma: Our Experiences With 21 Patients

2009 ◽  
Vol 19 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Zahra Eftekhar ◽  
Narges Izadi-Mood ◽  
Fariba Yarandi ◽  
Hadi Shojaei ◽  
Zahra Rezaei ◽  
...  
Keyword(s):  
Therapeutic Response ◽  
Endometrial Adenocarcinoma ◽  
Initial Response ◽  
Response To Therapy ◽  
Megestrol Acetate ◽  
Dilatation And Curettage ◽  
Stage Ia ◽  
The Mean ◽  
Well Differentiated ◽  
A Prospective Study

Background:There are therapeutic dilemmas regarding fertility-preserving treatment among young women with well-differentiated endometrial carcinoma.Materials and Methods:Twenty-one patients with stage IA well-differentiated endometrial adenocarcinoma were enrolled in a prospective study. The treatment initiated with 160 mg/d of megestrol acetate. The patients underwent dilatation and curettage and hysteroscopy after 3 months, and in cases of normal pathology, the therapy continued for another 3-month period. In patients who did not respond to treatment, the dosage of the drug was doubled (320 mg/d), and the therapy continued for another 3 months. At the second time, patients who did not respond to treatment were recommended for hysterectomy, and in patients who responded to treatment, an additional 3 months of treatment with megestrol acetate (320 mg/d) was administered.Results:Our results showed a response rate of 85.71% (18 patients), and 3 patients underwent hysterectomy. The mean (SD) treatment duration was 8.85 (2.00) months (range, 6-12 months). The response to therapy was observed in 5 patients (27.78%) with a dosage of 160 mg/d, and the remaining patients with 320 mg/d. Pregnancy occurred in 5 patients (27.78%). Recurrence happened in 3 (16.67%) of 18 patients who responded to treatment who did not give a permit to undergo hysterectomy and received medication again. Two (66.67%) of these patients experienced remission again, whereas the other one was candidate for hysterectomy.Conclusions:The results of this study show that, when an initial response is not achieved or when disease recurs, use of 320 mg/d seems to be associated with a better therapeutic response. Furthermore, serious complications were not observed with this dosage.

Retrospective analysis of stage IC uterine cancer patients: A single center experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15573-e15573
Author(s):  
Nadire Kucukoztas ◽  
Selim Yalcin ◽  
Samed Rahatli ◽  
Ozlem Ozen ◽  
Nihan Haberal ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Uterine Cancer ◽  
Endometrial Adenocarcinoma ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Surgical Staging ◽  
Increased Risk

e15573 Background: Stage IC patients are at an increased risk of recurrence and overall worse prognosis compared with stage IA and IB patients. Adjuvant chemoherapy is utilized based on specific pathologic factors. The objective of this study is to evaluate treatment outcomes at a single institution in patients with 1988 FIGO stage IC endometrial adenocarcinoma. Methods: Records of the patients with FIGO stage IB (formerly IC) endometrial cancer were retrospectively evaluated. All patients were initially treated surgically with comprehensive staging lymphadenectomy. Results: A total of 85 patients were included. Patient and tumor characteristics are shown in the table. Median age of the patients was 60 (range 27-95). Fifty-nine patients had at least one co-morbid disease. Complete surgical staging including pelvic and paraaortic lymph node dissection was performed in all the patients. Sixteen patients (19%) received adjuvant chemotherapy, including 6 patients with serous cancer and one patient with small cell cancer. Paclitaxel/carboplatin was the preferred regimen in Median follow up was 30 months (range 10-61 months). Seven patients (8%) relapsed and 4 patients (5%) died on follow up. 5 year disease free survival was 89% and overall survival was 95%. One of the 16 patients (6.2%) who received chemotherapy and 6 of the 69 patients (8.7%) who did not receive relapsed/died on follow up. Survival analysis was not performed because of the low number of events in both groups. Conclusions: We found similar rates of recurrence and death with previous studies in stage IC endometrial cancer. Complete surgical staging is the mainstay of treatment. Marginally lower recurrence rate in chemotherapy treated patients delineate the need for prospective randomized data addressing the role of adjuvant systemic therapy in early-stage patients with endometrial adenocarcinoma. [Table: see text]

scholarly journals The Revised 2009 FIGO Staging System for Endometrial Cancer: Should the 1988 FIGO Stages IA and IB Be Altered?

2011 ◽  
Vol 21 (3) ◽  
pp. 511-516 ◽  
Author(s):  
Nadeem R. Abu-Rustum ◽  
Qin Zhou ◽  
Alexia Iasonos ◽  
Kaled M. Alektiar ◽  
Mario M. Leitao ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prediction Models ◽  
Predictive Ability ◽  
Staging System ◽  
Stage I ◽  
Oncologic Outcomes ◽  
Figo Staging ◽  
Primary Surgery ◽  
Gynecology And Obstetrics ◽  
Stage Ia

ObjectivesThe revised 2009 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer included many changes over the 1988 system, particularly for stage I subgroups. We sought to describe the overall survival (OS) of women with stage I endometrial cancer and examine how the estimated stage-specific OS is altered in the 2009 system.MethodsA prospectively maintained institutional endometrial database was analyzed. All patients underwent primary surgery between January 1993 and June 2009.ResultsData from 1658 women were analyzed, including 1307 patients with FIGO 1988 stage I disease. The 5-year OS for the 1988 stages IA (92.4%), IB (87.3%), and IC (75.7%) significantly differed (P < 0.001). When patients were restaged using the 2009 system, we identified 1411 stage I patients with 5-year OS for 2009 stage IA of 89.2%, versus OS of 75.1% for IB (P = 0.001). The adjusted concordance probabilities for the 1988 stage I group and 2009 stage I group were 0.612 (SD, 0.0014) and 0.536 (SD, 0.0111), respectively.ConclusionsThe 1988 FIGO classification of stage I endometrial cancer correctly identified 3 subgroups of patients who had significantly different OS. Specifically, 1988 FIGO stages IA and IB had distinct oncologic outcomes. The revised 2009 system eliminates the most favorable group from the new classification system, and estimates of stage-specific OS for stage IB are substantially altered by the changes made in 2009. The revised system for stage I did not improve its predictive ability over the 1988 system. These data highlight the importance of developing individualized risk-prediction models and nomograms in endometrial cancer.

Survival after stage IA endometrial cancer; can follow-up be altered? A prospective nationwide Danish survey

2012 ◽  
Vol 91 (8) ◽  
pp. 976-982 ◽  
Author(s):  
HENRIK LAJER ◽  
SANDRA ELNEGAARD ◽  
RENÉ D. CHRISTENSEN ◽  
GITTE ORTOFT ◽  
DORIS E. SCHLEDERMANN ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Stage Ia ◽  
Danish Survey

scholarly journals Microbiota in Uterine Cavity of Unexplained Recurrent Spontaneous Abortion (URSA) Patients in Early Pregnancy

2021 ◽  
Author(s):  
Shiyu Bai ◽  
Shuai Fu ◽  
Liqiong Zhu ◽  
Manqi Chen ◽  
Bingqian Huang ◽  
...  
Keyword(s):  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Uterine Cavity ◽  
First Trimester ◽  
Recurrent Spontaneous Abortion ◽  
Control Group ◽  
Microbial Composition ◽  
Double Lumen ◽  
Unexplained Recurrent Spontaneous Abortion ◽  
Rrna Sequencing

Abstract Purpose The purpose of this study is to determine the uterine cavity microbial composition in unexplained recurrent spontaneous abortion (URSA) patients and to understand the correlation between URSA and uterine cavity microbiota. Methods Using the double-lumen embryo transfer tubes to collect uterine cavity fluid samples from pregnant women in their first trimester. 16S rRNA sequencing was conducted to analysis the composition and abundance of the microbiota in samples. Results We enrolled 10 URSA cases and 28 induced miscarriage cases in their early pregnancy. Microbial communities were detected in all samples of URSA group (100%, n = 10) vs. none of control group (0%, n=28). Two most dominant microbes are Lactobacillus and Curvibacter. Conclusion This study showed Lactobacillus and Curvibacter dominated colonizing in uterine cavity of URSA patients during early pregnancy and associated with URSA. Changes of dominant microbiota will lead to bad pregnancy outcome.

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