scholarly journals Successful Pregnancy Outcome after Laparoscopic Cerclage in a Patient with Cervicovaginal Fistula

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Giovanni Zanconato ◽  
Valentino Bergamini ◽  
Silvia Baggio ◽  
Elena Cavaliere ◽  
Massimo Franchi
Keyword(s):  
Obstetric Fistula ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Subsequent Pregnancy ◽  
Term Pregnancy ◽  
Successful Pregnancy ◽  
Obstructed Labor ◽  
Pregnant Uterus ◽  
History Of ◽  
Traumatic Origin

Obstetric fistula usually originates from obstructed labor or, less often, from invasive maneuvers on the genital tract or the pregnant uterus. Overall, it is a rare finding in the obstetric practice of high income countries. In this report we describe the case of a successful term pregnancy in a patient with a history of recurrent late miscarriage due to a large cervical fistula of traumatic origin, connecting the uterine cavity and the posterior vaginal fornix. A combined approach of laparoscopic cerclage and transvaginal fistula repair effectively restored cervical competence and created the conditions for a viable birth in a subsequent pregnancy. This unusual cause of cervical incompetence may be included in the indications which benefit from an abdominal cerclage carried out as a minimally invasive procedure in the nonpregnant state.

scholarly journals Successful Subsequent Pregnancy in a Woman Receiving Eculizumab for Pregnancy-Associated Atypical Haemolytic Uraemic Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Samantha Bateman ◽  
Maleeka Ladhani ◽  
Shilpanjali Jesudason
Keyword(s):  
Renal Function ◽  
Haemolytic Uraemic Syndrome ◽  
Rescue Therapy ◽  
Significant Risk ◽  
First Trimester ◽  
Subsequent Pregnancy ◽  
Baby Girl ◽  
Successful Pregnancy ◽  
Atypical Haemolytic Uraemic Syndrome ◽  
History Of

Atypical haemolytic uraemic syndrome (aHUS) is a form of thrombotic microangiopathy precipitated by unopposed complement activation, the treatment of which has been revolutionised by the availability of the monoclonal anti-complement (C5) antibody, eculizumab. Historically, women with aHUS would be unable to achieve a successful pregnancy due to the severity of their renal disease and for the few who could conceive, recurrence of aHUS was a significant risk. In spite of this, parenthood remains a priority for many. Experience with eculizumab use in the management of aHUS during pregnancy is growing and with it comes a significant change in the course of the disease. We present the case of a 28-year-old woman diagnosed with severe aHUS in the first trimester of her first pregnancy. She received rescue therapy with eculizumab and had a return to normal renal function. While this pregnancy was lost, she strongly desired a family. We managed her through a subsequent pregnancy while receiving eculizumab. This pregnancy was uncomplicated and carried to term and she birthed a healthy 2500 g baby girl. The complexities of managing a pregnancy in a woman with a history of aHUS are vast but not insurmountable, as demonstrated by this case.

scholarly journals Comparative evaluation of hysterosalpingo contrast sonography with laparoscopy for determination of tubal patency in infertility

2020 ◽  
Vol 9 (5) ◽  
pp. 2009
Author(s):  
Geetha Krishnamoorthy ◽  
Amutha Perumal ◽  
Chithra Boovaragasamy ◽  
Gnanamani Gnanasabai
Keyword(s):  
Screening Method ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tubal Patency ◽  
Infertile Women ◽  
Additional Information ◽  
History Of

Background: Tubal factor is responsible for infertility and is found in one of three infertile women. The current research was undertaken to compare the efficacy of hysterosalpingo contrast sonography (HyCoSy) with laparoscopy and chromopertubation in infertile women.Methods: A cross-sectional study was conducted from August 2016 to March 2017 among the patients attending outpatient department with complaints of primary or secondary infertility after obtaining written and informed consent. Detailed history of the patient was taken; clinical examination and necessary investigations were done. Data analysis was carried out using SPSS version 22.Results: All the HyCoSy findings showed excellent specificity (84-100%) and the sensitivity ranged from 40-87%.Conclusions: Study conclude that HyCoSy is a good screening method for evaluating uterine cavity lesions and tubal block in infertile women being safe, sensitive, cost effective, non-invasive procedure giving additional information regarding ovarian, adnexal and peritoneal pathology.

Stapled Surgery for Hemorrhoidal Prolapse: From the Beginning to the Modern Times

2020 ◽  
Vol 15 ◽  
Author(s):  
Alessandro Sturiale ◽  
Bernardina Fabiani ◽  
Claudia Menconi ◽  
Danilo Cafaro ◽  
Felipe Celedon Porzio ◽  
...  
Keyword(s):  
Postoperative Bleeding ◽  
Invasive Procedure ◽  
High Volume ◽  
Normal Mucosa ◽  
Stapled Hemorrhoidopexy ◽  
Wound Complications ◽  
Rectal Intussusception ◽  
Stapler Technique ◽  
History Of ◽  
Hemorrhoidal Prolapse

Introduction: Hemorrhoidal disease is the most common proctologic condition in adults. Among the different surgical procedures, one of the greatest innovations is represented by the stapled hemorrhoidopexy. The history of this technique started with a single stapler use passing thorough a double stapler technique to resect the adequate amount of prolapse, finally arriving to the use of high volume devices. Methods: Nevertheless each device has its own specific feature, the stapler is basically made up with one or more circular lines of titanium staples whose height may be variable. The procedure is based on different steps: Introduction of the CAD, evaluation of the prolapse, fashioning purse string or parachute suture, introduction of the stapler head beyond the suture, pull the wires through the window, close the stapler and keep pulled the wires of the suture held together with a forcep, fire using two hands, open the stapler and remove it and check the staple line and then check the specimen. One of the latest innovations in stapled surgery the Tissue Selective Therapy. It is a minimally invasive procedure in which there is a partial circular stapled hemorrhoidopexy focused on the prolapsing piles with bridges of normal mucosa left. Results: Several studies have reported that SH is a safe and effective procedure to treat the hemorrhoidal prolapse. It is a quicker procedure with a shorter hospital stay and earlier return to work if compared with the conventional treatment. This is due to a less postoperative pain, postoperative bleeding, wound complications and constipation. Furthermore, the first generation devices had worse outcomes if compared with those of the new generation stapler that showed lower postoperative complication rate with better anatomical and symptomatic results. Conclusions: Stapled procedure for the treatment of symptomatic hemorrhoidal prolapse represents one of the most important innovations in proctology of the last century bringing with it the new revolutionary concept of the rectal intussusception as a determining factor involved in the natural history of the disease. Stapled hemorrhoidopexy marked an era in which the surgeon may to offer to the patients a safe, effective treatment with less pain and fast recovery.

Successful pregnancy after localized resection of perforated uterus in choriocarcinoma and a literature review

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 445-448 ◽  
Author(s):  
N. Behtash ◽  
S. Ansari ◽  
F. Sarvi
Keyword(s):  
Acute Abdominal Pain ◽  
Young Patients ◽  
Rare Event ◽  
Myometrial Invasion ◽  
Exploratory Laparotomy ◽  
The Body ◽  
Uterine Perforation ◽  
Term Pregnancy ◽  
Successful Pregnancy ◽  
Future Fertility

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Rapid growth and myometrial invasion may be followed by uterine perforation. In this study, we present the cases of two young patients (18 and 19 years of age) with acute abdominal pain and shock, while they were under chemotherapy due to persistent trophoblastic disease. During emergent exploratory laparotomy, localized resection of uterus was performed. They had their first successful term pregnancy 5 and 4 years after surgery, respectively. Uterine perforation following choriocarcinoma is a rare event. Hysterectomy is recommended in emergency conditions, but localized resection of uterus should be considered in women who are desirous of future fertility.

Factitious Hematuria With Underlying Renal Abnormalities

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 377-379
Author(s):  
RICHARD F. SALMON ◽  
BILLY S. ARANT ◽  
MICHEL G. BAUM ◽  
RONALD J. HOGG
Keyword(s):  
Vesicoureteric Reflux ◽  
Term Pregnancy ◽  
Gross Hematuria ◽  
Persistent Symptoms ◽  
History Of ◽  
Appropriate Therapy ◽  
Complete Duplication ◽  
Renal Abnormalities ◽  
Recurrent Hematuria ◽  
Collecting System

Factitious hematuria is a well-described cause of hematuria in adult patients but is rarely seen or considered in children.1-6 In this article, a 5-year-old girl with a history of gross hematuria with more than one pathologic explanation for recurrent hematuria is described. Because of persistent symptoms despite appropriate therapy, a factitious cause was considered. CASE REPORT The patient was the healthy product of the uncomplicated full-term pregnancy of an unmarried woman who reared the child in the home of her mother and sister. The diagnosis of urinary tract infection was made first at 2 years of age. In subsequent radiographic studies, two normal kidneys were identified, with complete duplication of the left collecting system and bilateral grade 2 vesicoureteric reflux.

Pleuroscopy early experience in the exudative pleural effusion of unknown etiology

2021 ◽  
Vol 17 ◽  
Author(s):  
Atefeh Fakharian ◽  
Hamidreza Jabbardarjani ◽  
Mohamad Reza Masjedi ◽  
Masoud Shamaei
Keyword(s):  
Pleural Effusion ◽  
Previous History ◽  
Invasive Procedure ◽  
Therapeutic Interventions ◽  
Unknown Etiology ◽  
Safe Procedure ◽  
Pathologic Diagnosis ◽  
Medical Thoracoscopy ◽  
History Of ◽  
Exudative Pleural Effusion

Background: Pleuroscopy (medical thoracoscopy) is a minimally invasive procedure to inspect and perform a biopsy of the pleural space as well as to perform therapeutic interventions; pleural fluid drainage and pleurodesis. Material and Methods: In a retrospective study in Kasra Hospital, Tehran-Iran, the patients with exudative pleural effusion of unknown etiology who underwent pleuroscopy, were evaluated. These patients had negative smear and culture for infective agents. Also, the cytological review was negative for malignancy. Results: 62 patients had undergone pleuroscopy, of which 29 (46.7) were men. After the final evaluation, 47 patients (75.8%) had a definite pathologic diagnosis, of which 39 (82.9%) were cancer. Through these 39 cases, 18 cases (46.1%) had a history of the previously confirmed cancer, in which pleural pathology was consistent with the initial diagnosis. In 21 cases (53.9%), metastatic cancers were detected without a previous history. From a total of 47 cases with definite pathologic diagnosis, 8 cases (17%) had histopathologic evidence of granulomatous lesions consistent with tuberculosis and 15 patients (24%) showed non-specific inflammatory lesions. There was no morbidity and mortality among these patients. Discussion: Considering that pleuroscopy is a safe procedure with high diagnostic accuracy, malignancy is the most finding in the exudative pleural effusion of unknown etiology. This increases the importance of this procedure in these cases to prevent wasting the time and smear-negative anti-TB treatment.

scholarly journals Interpregnancy Body Mass Index Changes: Distribution and Impact on Adverse Pregnancy Outcomes in the Subsequent Pregnancy

2018 ◽  
Vol 36 (05) ◽  
pp. 517-521 ◽  
Author(s):  
Whitney Bender ◽  
Adi Hirshberg ◽  
Lisa Levine
Keyword(s):  
Body Mass Index ◽  
Preterm Birth ◽  
Body Mass ◽  
Pregnancy Outcomes ◽  
Subsequent Pregnancy ◽  
Adverse Pregnancy Outcomes ◽  
Increased Risk ◽  
History Of ◽  
Index Changes ◽  
Adverse Pregnancy

Objective To examine the change in body mass index (BMI) categories between pregnancies and its effect on adverse pregnancy outcomes. Study Design We performed a retrospective cohort study of women with two consecutive deliveries from 2005 to 2010. Analysis was limited to women with BMI recorded at <24 weeks for both pregnancies. Standard BMI categories were used. Adverse pregnancy outcomes included preterm birth at <37 weeks, intrauterine growth restriction (IUGR), pregnancy-related hypertension, and gestational diabetes mellitus (GDM). Women with increased BMI category between pregnancies were compared with those who remained in the same BMI category. Results In total, 537 women were included, of whom 125 (23%) increased BMI category. There was no association between increase in BMI category and risk of preterm birth, IUGR, or pregnancy-related hypertension. Women who increased BMI category had an increased odds of GDM compared with women who remained in the same BMI category (6.4 vs. 2.2%; p = 0.018). The increased risk remained after controlling for age, history of GDM, and starting BMI (adjusted odds ratio: 8.2; 95% confidence interval: 2.1–32.7; p = 0.003). Conclusion Almost one-quarter of women increased BMI categories between pregnancies. This modifiable risk factor has a significant impact on the risk of GDM.

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals Obstetric Fistula and Common Peroneal Nerve Palsy in a Rural Based Women: A Case Report

2015 ◽  
Vol 14 (1) ◽  
pp. 71-73
Author(s):  
Suchanda Das ◽  
Rokeya Begum ◽  
Bidhan Roy Chowdhury
Keyword(s):  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Common Peroneal Nerve ◽  
Home Delivery ◽  
Obstructed Labor ◽  
Labor Ward ◽  
Comprehensive Health ◽  
Common Peroneal Nerve Palsy ◽  
Maternal And Newborn

Neglected obstructed labor is a major cause of both maternal and newborn morbidity and mortality. By far the most severe and distressing long term morbidity following obstructed labor is obstetric fistula i.e. Vesicovaginal fistula. In developing countries fistula is commonly the result of prolonged obstructed labor. A18 year old primi gravida was admitted in the labor ward with the involuntary passage of stool and urine and unable to walk after 15 days of her home delivery. Temporary colostomy was done. Patient was on regular physiotherapy for prolonged time and she was responded slowly. There was a plan for repair of Vesicovaginal and Rectovaginal fistula. Obstructed labor complex is completely preventable if high quality basic and comprehensive health services are available to all. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22891 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 71-73

scholarly journals External fixator for the treatment of narrowed pelvic canal in a cat

2021 ◽  
Author(s):  
S Pinna ◽  
C Tassani ◽  
M Rossini ◽  
F Lanzi
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Clinical Examination ◽  
External Fixator ◽  
Invasive Procedure ◽  
Sacral Fracture ◽  
Minimally Invasive Procedure ◽  
Canal Stenosis ◽  
Applied Tension ◽  
History Of

The aim of this study was to report the outcome of the use of an external fixator to treat a pelvic canal stenosis in a 5-month-old female cat. The cat was referred with a history of 3 weeks of intermittent signs of constipation refractory to the medical management, occurring after surgical treatment for a bilateral sacroiliac luxation and sacral fracture. The clinical examination revealed instability of the pelvis and a radiograph showed a pelvic canal stenosis and megacolon. External fixator was the method of choice to be used in this case. The manually applied tension on an external fixator resulted in a widening of the pelvic canal. At 45 days after surgery, there were no signs of constipation, and the radiological examination showed progressive bone healing. At 18 months post-op, the cat had no abnormalities both on the clinical examination and on the radiography. In conclusion, the use of an external fixator led to the widening of the pelvic canal using a minimally invasive procedure. To the authors’ knowledge, this case report represents the first surgical description and clinical outcome of the widening of the pelvic canal in cats using an external skeletal fixator.

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