Determination of Gestational Age in Shami Goats Based on Transabdominal Ultrasonographic Measurements of Placentomes and Uterine Diameter

The study was aimed to estimate the gestational age of Shami does by transabdominal ultrasonographic measurement of maternal parameters. Thirty-three Shami does aged 2-2.5 years with confirmed conception dates were used. The does were examined in a standing position using a transabdominal 3.5 MHz convex sector probe of real-time ultrasonography. The does were examined weekly starting from 21 days of pregnancy until parturition. Measurements of the maternal parameters that include; the uterine diameter, placental width, and placental height were obtained from the ultrasonographic images using the software Screen Calipers. Results showed that the gestational sac and embryos were observed early on 21 and 35 days of pregnancy. The litter size of Shami does was 2-3 kids. Uterine diameter ranged between 27±1.4 and 136.9±4.2 mm between 21-130 days, placentomes width was 17.6±0.6 – 38.5±2.1 mm, placentomes height was 9.5 ± 1.8 – 24.5 ± 1.4 mm on 51-150 days of gestation. The highest positive correlations were obtained between the gestational age and the measurements of uterine diameter (r=0.943). The least positive correlations were between the gestational age and the values of placenta width (r=0.715) and placentom height (r=0.615). In conclusion, transabdominal ultrasonography is a practical method for pregnancy diagnosis and monitoring of embryo in Shami goats. Also, it is reliable to estimate gestation age from 21 days of pregnancy. The uterine diameter was the best maternal parameter that can be used for the longest period for estimation of Shami goats gestational age.

Ultrasound Modality in the Evaluation and Management of Gallbladder Polyps

Gallbladder polyps (GBP) are defined as developed masses inside the wall of the gallbladder; most of them (90%) are nontumor lesions. Abdominal ultrasound is the main and the first line radiological modality for their diagnosis and their risk lamination. We conducted a 12 year retrospective study between 2009 and 2020, which included patients who had preoperative transabdominal ultrasonography showing gallbladder polyps and had undergone cholecystectomy, and for whom postoperative pathology results were available, as well as patients who had at least one polyp discovered on the histopathological exam and who were not determined preoperatively. A total of 70 patients were identified. Preoperative diagnosis of vesicular polyp by ultrasound was carried in 82.9% of patients. The number of ultrasounds performed per person was 1.2 ± 0.47. The polyps’ size in mm was on average 6.14 ± 2.6 with extremes between 3 and 13 mm. On anatomopathological examination, a polyp was objectified in 33.3% of cases. In our series, abdominal ultrasound had a low sensitivity at 36.4%. We aim to provide the accuracy of abdominal ultrasound for the diagnosis of GBP, as a low-cost modality, and to evaluate the concordance of preoperative ultrasound imaging with postoperative pathology.

Giant hysteromyoma after vaginoplasty in a woman with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: case report and review of the literature

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients require surgery to create a neovagina, however, the preservation of a nonfunctional rudimentary uterus after surgery may lead to long-term complications. Herein, a rare case of a giant hysteromyoma after vaginoplasty, in a 31-year-old Chinese female patient who was diagnosed with MRKH syndrome, is reported. The patient, who had undergone vaginal reconstruction 4 years previously, presented with abdominal distension for the previous 2 weeks. Transabdominal ultrasonography showed a firm mass of approximately 10 × 10 cm in the lower abdomen. The patient subsequently underwent an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed. Beside this case, seven cases, published between 2004 and 2020, were identified during a literature search. Findings of the present and previously published cases suggest that gynaecologists should pay particular attention to the risks of pelvic complications in female patients with MRKH syndrome who have previously undergone surgery, and select appropriate therapeutic methods.

The Effects of Ram Exposure, Progestogen and eCG on Reproductive Performance of Fat Tail Ewes in Non-Breeding Season

Sheep are considered short-day breeders. Exposure of rams to anestrus ewes results in an increase in LH secretion. The aims of this study was to determine whether the presence and exposure of rams can effect on reproductive performance such as: pregnancy rate, litter size, sex of lamb, fecundity rate and prolificacy rate of fat tail Iranian Shaal breed ewes in non-breeding season using progesterone (p4) analogue with or without equine chorionic gonadotropin (eCG). Totally, 100 ewes out of 138 non-cyclic ewes with <0.5ng/ml P4 were selected for this study. They were aged 2 to >7 years old. They were stratified to two groups (control and treatment). The ewes in treatment and control groups received 13 days a sponge containing 60 mg medroxyprogesterone acetate (MPA). The treatment group consists of 3 subgroups and each group contains 25 ewes equally. They were included: 1- P4, eCG and Ram exposure. 2- P4 and ram exposure. 3- P4 and eCG. Ewes in control group received only P4. The ewes were located in isolated corrals for 40 days. The ram to ewe ratio was 1 to 5. Twenty healthy rams were housed in an isolated pen from ewes with distance 1500 m during 40 days. Rams exposed three days before sponge withdraw (day 10). They were separated by considerable distance (2 meters) using fence. The related groups received 500 IU eCG on the day of sponge removal (day 13). The rams were released into the ewe flock after removing the sponge in treatment and control groups. Pregnancy diagnosis performed using transabdominal ultrasonography. The obtained data analyzed using SPSS version 16. The conception rate in treatment and control groups were differed significantly (P<0.01). The conception rate in P4+ram exposure+ eCG, P4+ramexposure and P4+ eCG were 96%(no.24), 80%(no.20) and 88%(no.22), respectively. However, the conception rate in control group was 60% (no. 15). The fecundity rates were 136%, 100% and 124% in treatment subgroups, however, it was 84% in control group, respectively. There were no significant differences among genus and weight of lambs in treatments subgroups and control group (P>0.05). It is concluded that ram exposure can increase significantly reproductive performance in non-breeding season fat tailed ewes Shaal breed.

Covid-19 on Routine Testing In Eclampsia: A Duo Complication to Look out for in Pregnancy

Background: Coronavirus Disease 2019 (COVID-19) has been associated with adverse pregnancy outcomes including preeclampsia. COVID-19 and pre-eclampsia have overlapping clinical features therefore challenging to differentiate. Since COVID-19 is not routinely tested among pregnant women, it’s prudent to test it among patients presenting with Pre-eclampsia-Eclampsia. Case Presentation: A 23 year old female Gravida 1 Para 0 at 36 weeks and 5 days of amenorrhea presented at Mal Super Specialty Hospital as a referral in a semi-conscious state after a severe attack of tonic-clonic seizures. Detailed history from the husband was insignificant except for a persistent cough for the last 7 days. She had denied any visual changes, headaches or vaginal discharge. Physical examination revealed a tachycardia (150 bpm), elevated blood pressure (187/111 mmHg), a tachypnea (36 breaths/minute) and SPO2 of 94% at room air. Routine COVID-19 Rapid test turned positive, and the urine dipstick was +3. Additional tests revealed a leukocytosis and elevated liver enzymes. Chest radiograph revealed prominent interstitial markings and a bedside transabdominal ultrasonography showed a live single intrauterine fetus in cephalic presentation with normal cardiac activity and movements. A diagnosis of a prime gravida with eclampsia and COVID-19 was made. She was managed with intravenous labetalol, she had already received a loading dose of IV Magnesium sulphate and we administered two maintenance doses during monitoring. Within an hour of admission, she had a spontaneous rupture of the amniotic membranes, with meconium stained liquor (grade 2), and the fetal heart rate (148 beats per minute) was reassuring. She had an uncomplicated vaginal delivery of a live male newborn. Shortly after delivery, she developed slight respiratory distress and significant fluid overload that was managed with furosemide. A COVID-19 RT-PCR came back negative for the neonate and positive for the mother. She was shifted to the COVID-19 treatment unit and contact limited with the child. She was kept on a course of tablets Ivermectin, zinc, vitamin C, a montelukast, azithromycin, metronidazole and injectable pantoprazole. They were discharged on day 15 after recovery with a negative COVID nasopharyngeal swab. Conclusion: A diagnosis of pre-eclampsia-Eclampsia should prompt testing for COVID-19.

Dysmenorrhea and endometriosis in teenage girls (review)

Most adolescents experience discomfort during menstruation. Usually, girls are diagnosed with primary dysmenorrhea in the early reproductive period and respond well to symptomatic treatment with non-steroidal anti-inflammatory or hormonal drugs. If first-line therapy does not improve the symptoms of dysmenorrhea, transabdominal ultrasonography is indicated. Most often, these patients are diagnosed with endometriosis, which is the main cause of secondary dysmenorrhea in adolescents. Endometriosis should be assumed in patients with persistent, clinically pronounced dysmenorrhea that does not respond to treatment with hormonal drugs and non-steroidal anti-inflammatory drugs, especially if no other cause of chronic pelvic pain or secondary dysmenorrhea is detected on the basis of history, physical examination, and ultrasonography of pelvic organs. The aim of the therapy is to relieve symptoms, suppress disease progression, and protect future fertility.

Giant Hysteromyoma After Vaginoplasty in a Woman With Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Case Report and Review of the Literature

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients may need an operation to create a neovagina. However, the preservation of nonfunctional rudimentary uteri after surgery usually leads to some long-term complications. Case presentation: We report a rare case of a giant hysteromyoma after vaginoplasty in a woman with MRKH syndrome. A 31-year-old Chinese woman who was diagnosed with MRKH syndrome and received vaginal reconstruction 4 years ago presented with abdominal distension for half a month. Transabdominal ultrasonography showed a firm mass of approximately 10 x 10 cm in the lower abdomen. She then received an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed.Conclusions: Gynecologists should pay attention to the risks of pelvic complications in women with MRKH syndrome who have undergone previous surgery and then choose suitable therapeutic methods.

The Importance of the Novel Postpartum Uterine Ultrasonographic Scale in Numerical Assessments of Uterine Involution Regarding Perinatal Maternal and Fetal Outcomes

Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). A total of 131 consecutive patients admitted for delivery in the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, were prospectively evaluated using the PUUS method. The mean age was 27.72 years old, and they were examined during the first 24–48 h after vaginal delivery, or in the first 48–72 h after cesarean delivery. For patients with a PUUS grade greater than 1, re-examination was preformed daily in the following days, until the PUUS grade decreased to 1 or 0. Results: By standardizing uterine involution in a numerical fashion, we precisely demonstrate that uterine involution varied with the method of delivery (vaginal/cesarean) and with the number of vials of oxytocin received intrapartum, but not with the number of vials of ergometrine maleate received, and not with the origin of the parturient (rural/urban).