Myomectomy scar pregnancy ‒ a serious, but scarcely reported entity: literature review and an instructive case

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Marcela Toro-Bejarano ◽  
Robert Mora ◽  
Ilan E. Timor-Tritsch ◽  
Jessica Vernon ◽  
Ana Monteagudo ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Pregnancy Complication ◽  
Reproductive Age ◽  
Case Presentation ◽  
Clinical Appearance ◽  
Uterine Myomas ◽  
Placental Site ◽  
Relative Rarity ◽  
Placenta Accreta Spectrum ◽  
Us Scan

Abstract Objectives Uterine myomas are a frequent finding in reproductive age women with an estimated incidence 12–25%. 1. Treatment of uterine myomas to facilitate good pregnancy rates and outcome, such as hysteroscopic, laparoscopic, abdominal resection uterine artery embolization among others were evaluated in terms of pregnancy outcome. While the literature is replete of the pregnancy complication of uterine rupture after myomectomies, 2–4 there are very few publications evaluate a relatively rare pregnancy complication associated with placental implantation within the uterine cavity at the site of the previous myomectomy, namely the myomectomy scar pregnancy (MSP). Despite their relative rarity, this type of pathologically adherent placenta rightfully belongs to the well-known entity of placenta accreta spectrum (PAS). Case presentation We present a complicated case of MSP and review the available literature to raise attention to its clinical appearance, its prenatal diagnosis so appropriate intrapartum management can be planned. Conclusions Despite the rarity of MSP, continuous attention should be given at every single routinely scheduled or indication driven obstetrical US scan following myomectomies to evaluate the placental site implantation regardless of the route and technique of their initial surgical procedure.

scholarly journals Analysis of Reciprocally Dysregulated miRNAs in Eutopic Endometrium Is a Promising Approach for Low Invasive Diagnostics of Adenomyosis

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 782
Author(s):  
Evgeny Borisov ◽  
Margarita Knyazeva ◽  
Veronika Novak ◽  
Lidia Zabegina ◽  
Tatyana Prisyazhnaya ◽  
...  
Keyword(s):  
Social Impact ◽  
Uterine Cavity ◽  
Microrna Expression ◽  
Reproductive Age ◽  
Expression Ratio ◽  
Eutopic Endometrium ◽  
Clinical Appearance ◽  
Invasive Method ◽  
Magnetic Resonance Imaging Mri ◽  
Invasive Diagnostics

Endometriosis is a chronic disease characterized by the growth of endometrial tissue outside of the uterine cavity. Endometriosis affects up to 10% of women of reproductive age and has great social impact. The diagnostics of endometriosis are based on clinical appearance, ultrasound, and magnetic resonance imaging (MRI); however, a diagnosis is frequently hampered by the absence of objective criteria. Adenomyosis (AM) is a particular type of endometriosis wherein the spread of the ectopic endometrial gland is limited by the uterine myometrium. Alteration of the microRNA expression profile in the eutopic endometrium can be associated with AM, and may be assayed for diagnostic purposes. In the presented study, we aimed to explore the diagnostic potency of this approach. Eutopic endometrium specimens were collected from patients (n = 33) and healthy women (n = 30). The microRNA expression was profiled to select individual microRNAs with AM-associated expression alterations. A new method of two-tailed RT-qPCR microRNA analysis was applied to assay potential markers. The expression ratios of reciprocally dysregulated microRNAs were calculated, and the diagnostic potency of these parameters was evaluated by receiver operation curve (ROC) analysis. Mir-10b, miR-200c and miR-191 were significantly dysregulated in the eutopic endometrium of AM patients. The expression ratio of reciprocally dysregulated microRNAs allowed us to diagnose AM with a range of sensitivity from 65% to 74%, and of specificity from 72% to 86%. The analysis of microRNAs from the eutopic endometrium might present a promising low-invasive method of AM diagnostics.

LIPID PEROXIDATION AND ANTIOXIDANT PROTECTION SYSTEM IN WOMEN WITH ENDOMETRIAL HYPERPLASTIC PROCESSES

2019 ◽  
pp. 44-49
Author(s):  
A.O. Atykanov ◽  
G.U. Asymbekova ◽  
A.A. Masybaeva
Keyword(s):  
Lipid Peroxidation ◽  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Support Network ◽  
Antioxidant Protection ◽  
Women Of Reproductive Age ◽  
Atypical Form ◽  
Antioxidant Protection System ◽  
Quantitative Indicators

The paper presents quantitative indicators of lipid peroxidation (LP) products and antioxidant support network (ASN) in blood plasma in women with various histological forms of endometrial hyperplastic processes (EHPs). The goal of the paper is to assess the state of LP processes and ASN in women of reproductive age with various forms of EHPs. Materials and Methods. The trial enrolled 137 women of reproductive age: 112 women with endometrial hyperplasia (EH) and 25 women with uterine cavity synechia without EH. Conclusion. In case if EH progresses from a simple atypical form to adenocarcinoma, an increase in lipid peroxidation intensity and ASN inhibition is observed. Keywords: women, endometrial hyperplastic processes, endometrial hyperplasia, lipid peroxidation, antioxidant support network. В работе представлены количественные показатели содержания продуктов перекисного окисления липидов (ПОЛ) и системы антиоксидантной защиты (АОЗ) в плазме крови у женщин с различными гистологическими формами гиперпластического процесса эндометрия (ГПЭ). Цель исследования. Оценить состояние процессов ПОЛ и системы АОЗ при развитии различных форм ГПЭ у женщин репродуктивного возраста. Материалы и методы. Объектом исследования явились 137 женщин репродуктивного возраста: 112 женщин с гиперплазией эндометрия (ГЭ) и 25 женщин с синехиями полости матки без ГЭ. Выводы. При прогрессировании ГЭ от простой неатипичной до аденокарциномы происходит нарастание интенсивности липопереокисления и угнетения системы АОЗ. Ключевые слова: женщины, гиперпластические процессы эндометрия, гиперплазия эндометрия, перекисное окисление липидов, система антиоксидантной защиты.

scholarly journals Vaginal, Cervical and Uterine pH in Women with Normal and Abnormal Vaginal Microbiota

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 90
Author(s):  
Malene Risager Lykke ◽  
Naja Becher ◽  
Thor Haahr ◽  
Ebbe Boedtkjer ◽  
Jørgen Skov Jensen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Genital Tract ◽  
Quantitative Polymerase Chain Reaction ◽  
Female Genital Tract ◽  
Uterine Cavity ◽  
Vaginal Microbiota ◽  
Reproductive Age ◽  
Ph Gradient ◽  
Increased Risk ◽  
Female Genital

Introduction: Healthy women of reproductive age have a vaginal pH around 4.5, whereas little is known about pH in the upper genital tract. A shift in the vaginal microbiota may result in an elevated pH in the upper genital tract. This might contribute to decreased fertility and increased risk of preterm birth. Therefore, we aimed to measure pH in different compartments of the female genital tract in both nonpregnant and pregnant women, stratifying into a normal and abnormal vaginal microbiota. Material and methods: In this descriptive study, we included 6 nonpregnant, 12 early-pregnant, and 8 term-pregnant women. A pH gradient was recorded with a flexible pH probe. An abnormal vaginal microbiota was diagnosed by a quantitative polymerase chain reaction technique for Atopobium vaginae; Sneathia sanguinegens; Leptotrichia amnionii; bacterial vaginosis-associated bacterium 1, 2, 3, and TM7; and Prevotella spp. among others. Results: In all participants we found the pH gradient in the lower reproductive canal to be most acidic in the lower vagina and most alkaline in the upper uterine cavity. Women with an abnormal vaginal microbiota had an increased pH in the lower vagina compared to the other groups. Conclusions: There is a pronounced pH gradient within the female genital tract. This gradient is not disrupted in women with an abnormal vaginal microbiota.

scholarly journals A Rare Gestational Trophoblastic Disease: Placental Site Trophoblastic Tumor

2016 ◽  
Author(s):  
Senem Yaman Tunç ◽  
Elif Ağaçayak ◽  
Mehmet Sait İçen ◽  
Serdar Başaranoğlu ◽  
Mehmet Sıddık Evsen ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Tumor ◽  
Trophoblastic Cells ◽  
Placental Site ◽  
Gestational Trophoblastic Diseases ◽  
Abnormal Vaginal Bleeding

<p>Placental site trophoblastic tumor (PSTT) is a highly rare form of gestational trophoblastic diseases that arise from intermediate trophoblastic cells. By presenting this case, we aimed to review the treatment and diagnosis, approach to PSTT.<br />A 31-year-old (G2P1A1L1) patient had abnormal vaginal bleeding. Serum ß-HCG was 5.82 mIU/ml and the transvaginal USG detected a polypoid mass in uterine cavity. Probe curettage was performed. Histopathologic specimens were confirmed as PSTT. No metastasis was detected. A total abdominal hysterectomy was performed.<br />PSTT is a rare tumor. In contrast to other trophoblastic tumors, PSTT produces a small amount of ß-HCG and it is relatively insensitive to chemotherapy. Adjuvant chemotherapy is suggested to follow surgical treatment in the cases with metastasis.</p>

scholarly journals Endometrial Infertility in Patients of Late Reproductive age (a review)

2020 ◽  
Vol 27 (6) ◽  
pp. 149-163
Author(s):  
K. V. Uryupina ◽  
I. I. Kutsenko ◽  
E. I. Kravtsova ◽  
J. V. Kudlai ◽  
I. I. Kravtsov
Keyword(s):  
Assisted Reproduction ◽  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Endometrial Receptivity ◽  
Female Infertility ◽  
Reproductive Age ◽  
Local Immunity ◽  
Age Related ◽  
Choice Of Treatment ◽  
Uterine Infertility

Background. Endometrial infertility is a frequent cause of failure in assisted reproduction. Causes of endometrial infertility are manifold and require comprehensive assessment for a successful choice of treatment strategy.Objectives. A review of infertility concepts accounting for endometrial infertility in women of late reproductive age.Methods. Bibliographic analysis: sources for review were mined in the PubMed, MedLine, eLibrary and Cyberleninka databases at a depth of 10 years. Keyword queries were: endometrial factors of infertility, uterine infertility [маточные факторы бесплодия], causes of infertility. Selected articles related to female infertility and, particularly, endometrial factors of infertility. Low-informative articles were not considered.Results. A total of 51 sources were analysed, with 36 selected in the review. The reviewed evidence suggests that endometrial female infertility in late reproductive age is associated with cumulative gynaecological pathology and age-related change adversely impacting endometrial receptivity and synchrony with embryo maturation in assisted reproductive protocols.Conclusion. Determining the functional status of endometrium is prerequisite for the outcome prognosis in assisted reproduction due to feasible failures to conceive with a vital embryo but reduced endometrial receptivity. This observation warrants a timely diagnosis and treatment of endometrial disorders prior to having assisted reproductive interventions. Woman’s age is the main predictor of successful pregnancy in IVF/ICSI protocols. Among the main markers of successful implantation is endometrial thickness. Uterine infertility may relate to impaired local immunity and autoimmune responses in uterine cavity. The most common mechanisms of uterine infertility are associated uterine myoma, endometriosis and endometritis. Women with uterine infertility attempting IVF/ICSI procedures often exhibit asynchronous endometrial development relative to the embryo maturity for implantation.

scholarly journals Intraoral Sebaceous Carcinoma: Case Report of a Rare Tumor Emphasizing the Histopathological Differential Diagnosis

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Manveen Kaur Jawanda ◽  
R. V. Subramanyam ◽  
Harshaminder Grewal ◽  
Chitra Anandani ◽  
Ravi Narula
Keyword(s):  
Differential Diagnosis ◽  
Oral Cavity ◽  
Sebaceous Carcinoma ◽  
Rare Tumor ◽  
Radiographic Findings ◽  
Case Presentation ◽  
Clinical Appearance ◽  
Cutaneous Malignancy ◽  
The Face ◽  
Rare Malignancy

Background. Sebaceous carcinoma (SC) is an uncommon cutaneous malignancy, usually occurring predominantly in the eyelids and only occasionally involving the oral cavity. Sebaceous carcinoma (SC) is a rare malignancy. Only 10 cases of sebaceous carcinoma of the oral cavity have been reported so far. Case Presentation. A 40-year-old female presented with a mass on the left side of the middle third of the face. Radiographic findings were inconclusive. Resection of the mass was consistent with the diagnosis of primary sebaceous carcinoma. Conclusion. Intraoral sebaceous carcinoma is uncommon. Due to its varied clinical appearance and presence of a diverse histopathologic appearance, the diagnosis is quite often confounding and elusive. Hence, it is imperative to familiarize oneself about various aspects of this rare tumor for earlier diagnosis, to improve the chances of patient’s survival.

scholarly journals Endometrial polyps: Pathogenesis, sequelae and treatment

2019 ◽  
Vol 7 ◽  
pp. 205031211984824 ◽  
Author(s):  
Njume Peter Nijkang ◽  
Lyndal Anderson ◽  
Robert Markham ◽  
Frank Manconi
Keyword(s):  
Postmenopausal Women ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Asymptomatic Women

Endometrial polyps are overgrowths of endometrial glands that typically protrude into the uterine cavity. Endometrial polyps are benign in nature and affect both reproductive age and postmenopausal women. Although endometrial polyps are relatively common and may be accompanied by abnormally heavy bleeding at menstruation. In asymptomatic women, endometrial polyps may regress spontaneously, in symptomatic women endometrial polyps can be treated safely and efficiently with hysteroscopic excision.

scholarly journals COVID-19 Compromises In The Medical Practice And The Consequential Effect On Endometriosis Patients

2021 ◽  
Author(s):  
Shaked Ashkenazi ◽  
Ole Linvaag Huseby ◽  
Gard Kroken ◽  
Luis Adrian Soto ◽  
Marius Pents ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental State ◽  
Medical Management ◽  
Uterine Cavity ◽  
Well Being ◽  
Reproductive Age ◽  
Cross Sectional Survey ◽  
Keywords Endometriosis

Background and purpose In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, self-isolation practices aimed to curb the spread of COVID-19 have severely complicated the medical management of patients suffering from endometriosis and their physical and mental well- being. Endometriosis, the main cause for chronic pelvic pain (CPP), is a highly prevalent disease characterized by the presence of endometrial tissue in locations outside the uterine cavity that affects up to 10% of women in their reproductive age. This study aimed to explore the effects of the global COVID-19 pandemic on patients suffering from endometriosis across multiple countries, and to investigate the different approaches to the medical management of these patients based on their self- reported experiences. Methods A cross-sectional survey, partially based on validated quality of life questionnaires for endometriosis patients, was initially created in English, which was then reviewed by experts. Through the process of assessing face and content validity, the questionnaire was then translated to fifteen different languages following the WHO recommendations for medical translation. After evaluation, the questionnaire was converted into a web form and distributed across different platforms. An analysis of 2964 responses of participants from 59 countries suffering from self-reported endometriosis was then conducted. Results The data shows an association between COVID-19 imposed compromises with the reported worsening of the mental state of the participants, as well as with the aggravation of their symptoms. For the 1174 participants who had their medical appointments cancelled, 43.7% (n=513) reported that their symptoms had been aggravated, and 49.3% (n=579) reported that their mental state had worsened. In comparison, of the 1180 participants who kept their appointments, only 29.4% (n=347) stated that their symptoms had been aggravated, and 27.5% (n=325) stated their mental health had worsened. 610 participants did not have medical appointments scheduled, and these participants follow a similar pattern as the participants who kept their appointments, with 29.0% (n=177) reporting aggravation of symptoms and 28.2% (n=172) reporting that their mental state had worsened. Conclusions These findings suggest that COVID-19 pandemic has had a clinically significant negative effect on the mental and physical well-being of participants suffering from endometriosis based on their self-reported experiences. Thus, they show the importance of further assessment and reevaluation of the current and future management of this condition in medical practices worldwide. Keywords Endometriosis, COVID-19, questionnaire, Quality of life, Mental health, Physical health

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