scholarly journals Is it safe to perform myomectomy in first trimester of pregnancy? The report of two cases

2021 ◽  
Vol 6 (2) ◽  
pp. 170-174
Author(s):  
Murat Celiloglu ◽  
◽  
Samican Ozmen ◽  
Sefa Kurt ◽  
Orkun Ilgen

Uterine fibroids are the most common benign tumors in women in the reproductive age group. The incidence of fibroids during pregnancy varies between 1.6 and 10.7%. In 10% of these cases, fibroids lead to complications. The management in symptomatic patients is conservative, and the surgical treatment is delayed until after birth due to its risks. In the last two decades, it has been shown that myomectomy can be an alternative treatment in selected cases, especially in second-trimester pregnancies. However, the data on the success of myomectomies performed earlier in pregnancy are limited. In this case report, we present two cases who were admitted to our clinic during the first trimester of pregnancy and had complicated fibroids. The diagnosis, the follow up and the treatment are presented with the review of the literature.

Author(s):  
Manpreet Kaur ◽  
Rajiv Kamal Gupta ◽  
Simrat Jit Kaur ◽  
Panchampreet Kaur

Background: Leiomyomas are benign tumors of smooth muscle cells commonly encountered in women of reproductive age group. Aim of this study was to conduct a histopathological study of leiomyomas in hysterectomy specimens and to correlate them with clinical findings.Methods: A prospective study was done on 130 hysterectomy specimens clinically diagnosed as leiomyoma. The specimens were subjected to histopathological examination.Results: In this study, the most common age group was 31-50 years (87.69%). Most common complaint was menorrhagia (51.54%). In endometrium, the most common histopathological diagnosis was proliferative phase (46.15%) followed by endometrial hyperplasia (19.23%). The most common secondary change was hyalinization and the most common site was intramural (62.9%).Conclusions: Hysterectomy is a commonly performed procedure in the management of uterine leiomyomas. The ultimate diagnosis and prognosis depends on the histopathological examination; therefore, every operated specimen must be subjected to histopathology. 


2018 ◽  
Vol 8 (1) ◽  
pp. 2-6
Author(s):  
Sangeeta Devi Gurung ◽  
Prakash Sharma

Introduction: Ectopic pregnancy (EP) is one of the major complications in first trimester pregnancy, resulting in increased maternal morbidity and mortality. It accounts for 1.3-2.4% of all pregnancies. Previously, though laparoscopy was considered as the gold standard for diagnosis of ectopic pregnancy, due to availability of high resolution ultrasound, it has become the first line investigation for the diagnosis of ectopic pregnancy.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara, from January 2015 till December 2017. All the cases diagnosed with ectopic pregnancy were included in the study.  Ultrasonological and intraoperative findings were recorded. Data was analyzed using SPSS (VERSION 16).Results: Twenty six patients were diagnosed with ectopic pregnancies. The incidence was 0.35%. It was most common among the reproductive age group between 20-40 years with mean age of 30.50 years. Pelvic inflammatory disease (n=10, 38.5%) was considered as risk factor. Radiological finding of Type III ectopic pregnancy (n=21, 80.8%) was the most common type.Conclusion: Ectopic pregnancy is common among reproductive age group with previous history of pelvic inflammatory disease. Type III is the most common type.


2018 ◽  
Vol 19 (2) ◽  
pp. 92
Author(s):  
Md Sunny Anam Chowdhury ◽  
Sadia Sultana ◽  
Md Abdul Awal ◽  
Suraya Sarmin ◽  
Mohammad Simoon Salekin

<p><strong>Objective</strong>: This interventional study has undertaken to assess the gonadal function of differentiated thyroid cancer (DTC) patients within reproductive age group following single dose of radioactive iodine (131I) therapy/ablation.</p><p><strong>Patients and Methods:<em> </em></strong>A total of 69 patients (25 male and 44 female) of DTC were included in this study, those were referred for 131I ablation after total thyroidectomy. Following RAI, these patients were followed-up three times at three months interval.  The usual I-131 dose was 75 or 100 m Ci for ablation of thyroid residues and 150 mCi for treatment of nodal metastasis. All the patients were interviewed about menstrual (female only) and reproductive history and investigated of the level of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone of male patients and FSH, LH, estradiol (E<sub>2</sub>) of female patients before administration of  131I and three, six and nine months after therapy.</p><p><strong>Result</strong>: In this study all of the 25 (100.0%) male patients showed high FSH level after three months of therapy. The mean± SD FSH level of male patients was found significantly (p-0.001) higher (15.59±7.53 IU/L) after three months of therapy than the pretherapy (4.85±2.57 IU/L) level.  The mean± SD of FSH level was significantly declining in six months and nine months of follow up. The mean± SD of LH hormone level of these patients was found 6.1±3.67 IU/L in pretherapy which was significantly increased to 7.67±4.33 IU/L after three months. The mean LH level was 7.20±3.98 IU/L at six months follow up and 7.3±3.5IU/L after nine months. The differences of LH level between 3 months to 6 months and 6 months to 9 months are not statistically significant. No significant change was observed in testosterone level throughout the study period. In female, five patients developed irregular menstruation (changed duration of cycle or lighter amount), three patients developed amenorrhea associated with hot flashes within six months of 131I administration. Biochemical study of the patients with amenorrhoea showed markedly elevated serum FSH, LH level and declined E<sub>2 </sub>level. The FSH, LH levels of the two patients with amenorrhea became normal within study period and one patient had persistent amenorrhea at 9 months. E<sub>2</sub> level raised slowly.</p><p><strong>Conclusion</strong>: A single dose of radio-iodine (131I) therapy causes impairment of gonadal function of male patients within reproductive age group. In case of female patients the effect is insignificant. The effect is usually reversible and gonadal function of the patients restores within the study period.</p><p>Bangladesh J. Nuclear Med. 19(2): 92-97, July 2016  </p>


Author(s):  
Amanat Sidhu ◽  
Ripan Bala ◽  
Pooja Tandon ◽  
Rajdeep Chhina

Endometriosis is the presence of endometrial tissue outside the uterus. Endometriosis affects 10-15% of all women in reproductive age group and 70% of the women with chronic pelvic pain. The risk of malignant transformation in an endometrioma has been reported to be low, though there is an increased risk for certain gynecological as well as non-gynecological carcinomas with endometriosis. We present a case diagnosed as having endometrioma transforming into a malignant tumor in a young female. We intend to emphasize that all the clinicians should make their patients aware of the malignant potential of endometriosis and a strict follow up of all cases being treated conservatively should be a must.


2021 ◽  
Author(s):  
Adaiah Priscillia Soibi-Harry ◽  
Christian Makwe ◽  
Ayodeji Ayotunde Oluwole ◽  
Sunusi-Rimi Garba ◽  
Abisoye Towuromola Ajayi ◽  
...  

ABSTRACT Background: Uterine fibroid is the most common benign gynaecological tumour in women of reproductive age group, with significant impact on the quality of life, economy, morbidity and sometimes mortality of affected women. Black women of reproductive age group are more likely to develop uterine fibroids. Although available evidence suggests racial and genetic predisposition to the aetiology of uterine fibroid, oxidative stress has been implicated in the onset and progression of uterine fibroids. Epidemiological and experimental studies have suggested that oxidative stress may play an important role in the pathogenesis of gynaecological diseases including uterine fibroids. Aim and Objectives: This study aims to assess the serum levels of antioxidants (catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx)) and oxidants (protein carbonyl (PC), advanced oxidation protein products (AOPP)) in women with uterine fibroids and to identify any association between the size of uterine fibroids and serum levels of the analysed antioxidants and oxidants. Methods: Forty-four women with ultrasound diagnosis of uterine fibroids and 44 women without uterine fibroids were recruited from a University Teaching Hospital. Blood samples were obtained and analysed for serum levels of selected antioxidants (CAT, SOD, GPx) and oxidants (PC, AOPP). Pelvic ultrasonography was performed on all study participants. Results: The median serum levels of antioxidants: CAT (2.20 vs 4.32 ng/ml; p < 0.001); SOD (285.54 vs 380.96 ng/ml; p < 0.001) and GPx (9.67 vs 11.26 uU/ml; p < 0.001) were significantly lower in women with uterine fibroids. The median serum levels of oxidants: PC (162.08 vs 142.36 ng/ml; p = 0.04); and AOPP (22.42 vs 13.94 ng/ml; p < 0.001) were significantly higher in women with uterine fibroids. There was a strong negative correlation between serum levels of AOPP and SOD (r = -0.95; p < 0.001) in women with uterine fibroids. The maximum diameter of fibroids showed a significant positive correlation with AOPP (r = 1.000; p < 0.001) and a negative correlation with SOD (r = -1.000; p < 0.001). Conclusion: Women with uterine fibroids had lower levels of antioxidants and higher levels of oxidants. In women with uterine fibroids, AOPP negatively correlated with SOD. There was a positive correlation between fibroid size and AOPP and a negative correlation between fibroid size and SOD. The findings of this study suggests that AOPP and SOD may play an important role in uterine fibroids. Keywords: Uterine fibroids; Oxidative stress markers; antioxidants; oxidants


Author(s):  
Dharitri Swain ◽  
Chanchal Yadav ◽  
Jyoti Kumari ◽  
Monika Rani ◽  
Priyanka Daunrai Rongmei ◽  
...  

Background: Uterine fibroid is the most common pelvic tumor in women of reproductive age and are asymptomatic in at least 50% of affected women. Various risk factors are associated with development of uterine fibroids during this reproductive age. The present study established various associated risk factors increases the prevalence of uterine fibroid among reproductive age group and clinical symptoms burden of diagnosed case.Methods: A cross sectional study design was used to collect samples for a period of six months in an OPD basis. Purposive sampling technique was used to select the 362 sample of reproductive age group (15-45 years) women in a tertiary care hospital, Southeastern India. Women diagnosed with uterine fibroid by ultrasonography were included as cases. Symptomatic features and associated risk factors of UF were collected through structure interview schedule.Results: Point prevalence of uterine fibroid among women in reproductive age group during the period of six months was 20%. Majority of them were in the age group of 30-39 years. Demographic factor such as overweight and obesity and consume dairy products daily has increased the prevalence of UF, whereas use of oral contraceptive pills and normal BMI had inverse relationship with UF risk. Most of the cases reported of having menstrual disturbances like heavy bleeding, passes blood clots during menstruation, prolonged period, urinary symptoms and pressure symptoms were considered independent predicting factors for the occurrence of uterine fibroid.Conclusions: Uterine fibroid is more prevalent among women of reproductive age causing various bleeding and renal symptoms that can have negative impact on quality of women’s life.


Author(s):  
Ashish R. Kale

Background: Present study was a randomised prospective observational study carried out at Ashakiran Hospital and IVF centre Pune, Maharashtra, India to evaluate the efficacy, safety, and quality of life by using Ulipristal acetate 10 mg and Mifepristone 25 mg daily doses to treat uterine fibroids of two subgroups involving fibroids <3 cm and fibroids 3 to 5 cm all are in reproductive age group with symptomatic in nature over 3 months.Methods: A total number of 40 patients were recruited in the study of which they were divided into two groups according to the size of the fibroid as <3cm and 3-5cm as seen on transvaginal as well as transabdominal ultrasound. Further they were randomly assigned to either mifepristone or ulipristal orally with each category having 10 patients each to assess changes in fibroid size, in symptomatic pain reduction, menorrhagia and in quality of life.Results: The 25-mg dosage of Mifepristone is shown to be a good and effective way of treatment in fibroids less than 3 cm in achieving 40% reduction in size and 50% reduction in menorrhagia as compared to Ulipristal 10 mg which acts better in other subgroup of size 3-5 cm of fibroids.Conclusions: Still larger RCTs are needed to study the long-term benefits of these drugs.


Author(s):  
Mahati Sundar ◽  
Chitra Srinivasan

Leiomyomas are benign tumors of the uterus affecting women of the reproductive age group. They are the most common gynaecologic neoplasms in women. The aim of our study was to analyse and correlate the histopathological findings of leiomyomas in 203 hysterectomy specimens received in the department of Pathology at Saveetha Medical College and to further delineate the associated changes and variants that were observed in the leiomyoma specimens. In this study we found that the dominant age group was 31-50 years of age with multiple leiomyomas being more common than solitary ones. The most commonly observed location was intramural. Majority of the hysterectomy specimens showed a proliferative pattern of endometrium. Degenerative changes were observed in 26 cases with hyaline degeneration being the most common secondary change. There were multiple uterine pathologies associated with the uterine leiomyomas of which ovarian cortical cysts were the most frequently noted. The histopathological study of leiomyomas is important as it helps to further ascertain the diagnosis and ensure optimal patient management.


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