Proceedings in Obstetrics and Gynecology
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Factors affecting the pre- and post-elective abortion contraception choices in Iowa
Get PDFTo characterize the contraceptive uses and identify contraceptive concerns and preferences among Iowa women seeking abortion
Polycystic kidney disease with unilateral ventriculomegaly: a case report
Get PDFPolycystic Kidney Disease (PKD) is an autosomal recessive disease with an incidence of about 1 in 30 000 births. It characterized by multiple cysts which filled by fluid that can ultimately impede kidney function leading to degeneration of renal tissue and renal failure. Oligo or anhydramnios is frequently present but not invariably so, suggesting that some degree of renal function is retained in some PKD cases. We present a 30 year old woman, gravida 5, para 4, at 22 weeks of gestation with ultrasound findings of autosomal recessive PKD, unilateral ventriculomegaly and marked oligohydramnios. Ventriculomegaly is a brain condition that occurs when the width of the atrium of the lateral ventricle is greater than 10 mm and occurs in 0.3-1.5 births per 1000. The association between autosomal recessive PKD and unilateral ventriculomegaly is not well understood and needs further evaluation
Intra-abdominal fibromatosis with vesico-colonic fistula: case of a benign disease running a malignant course
Get PDFIntra-abdominal fibromatosis is a rare benign tumor which can pose challenges in its management because of its local aggressive invasion and propensity for high recurrence. Here we report the case of a young woman who presented with a large intra-abdominal tumor with bilateral ureteric compression. This case highlights the risks of surgical intervention, the limitations of radiotherapy and subsequent complications that can develop over the years in such patients
The rat race of getting funded
Get PDFIn this creative writing piece, Dr. Thiel explores an alternate approach for the grant review process, ultimately concluding that the current pipeline is not inappropriately rigorous
Mark K. Santillan, MD
Get PDFDr. Mark Santillan, MD, brings a great deal of energy to his position as Assistant Professor in the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Iowa. As an active physician in the high-risk obstetrics clinic, researcher into the causes of preeclampsia, and Clinical Research Director for the Maternal Fetal Tissue Bank, that level of energy is a must
Sister Mary Joseph Nodule and peritoneal carcinomatosis from squamous cell cervical carcinoma
Get PDFSister Mary Joseph nodule is an eponym assigned to a nurse, first reported in 1949, denoting a rare form of cutaneous umbilical metastasis. The primary neoplasm is usually adenocarcinoma and the gastrointestinal tract is the most common primary site. The present case report describes a 79 year old woman with squamous cell cervical carcinoma. Her disease was managed with radiation and concurrent chemotherapy and no evidence of loco-regional recurrent disease was noted on follow-up examination. Eight months after treatment, gynecological examination suggested recurrent disease. Three weeks later, the patient presented with a painless umbilical nodule and the biopsy revealed a poorly differentiated carcinoma. Computed tomography showed ascites, diffuse peritoneal carcinomatosis including an umbilical nodule, multiple pulmonary nodules, bilateral pleural effusion, and retroperitoneal lymphadenopathy. She died 63 days after this manifestation. Review of the literature shows that a Sister Mary Joseph nodule is a sign of advanced neoplastic disease and is associated with poor prognosis. The treatment remains palliative either by radiation, chemotherapy or surgery
Is it essential to perform preoperative diagnostic curettage in patients scheduled for uterine myoma surgery?
Get PDFObjective: Uterine myoma, which arises from the myometrium of uterus, is among the most common benign tumors of women. Generally, it has an asymptomatic character, however, in symptomatic cases, it presents with abnormal uterine bleeding. The objective of this study is to determine whether preoperative diagnostic curettage is essential or not by comparing the preoperative and postoperative endometriums of patients that underwent surgery with uterine myoma diagnosis.Material and Method: In this study,260 patients that received surgery with uterine myoma diagnosis in the Gynecology and Obstetrics Department of Taksim Education and Research Hospital in Istanbul between January 2007 and January 2010, were included. The histopathologic analysis of specimens obtained by preoperative curettage and hysterectomy, was carried out in a retrospective fashion.Results: The mean age of patients was 48.3 ± 7.5 years. The distribution of preoperative curettage specimens with regard to endometrial status was as follows: phase compatible endometrium in 156 (60%), endometrial polyp in 74 (28.5%), atrophic endometrium in 20 (7.7%), and endometrial hyperplasia in 10 patients (3.8%). Among the phase compatible endometriums, 85 patients (54.5%) had proliferative endometrium, 39 patients (25%) had late secretory phase endometrium, and 32 patients (20.5%) had early secretory phase endometrium. The distribution of postoperative hysterectomy specimens with regard to endometrial status was as follows: Phase compatible endometrium in 160 patients (61.5%), endometrial polyp in 61 patients (22.5%), endometrial hyperplasia in 14 patients (5.4%), and atrophic endometrium in 25 patients (9.6%). Among the phase compatible endometriums; 96 patients (60%) had proliferative endometrium, 44 patients (27.5%) had late secretory endometrium, and 20 patients (12.5%) had early secretory endometrium.Conclusion: No difference was observed between the histopathologic results of diagnostic curettage and hysterectomy relative to malignancy or a pathology that would change the surgery plan. The result is very important because it shows that performing curettage before myoma surgery is not an essential procedure. In this study, since endometrial cancer may not have been detected due to limited number of patients, further studies including higher number of patients are required to confirm our results
Congenital cytomegaloviral infection as a risk factor for preterm birth
Get PDFCongenital cytomegalovirus (CMV) is the most common cause of congenital-acquired infection in the United States and preterm birth continues to be a world-wide public health problem. Given infection has been shown to play a role in preterm delivery; the objective of this study was to determine the prevalence of congenital CMV infection in a population of preterm infants and determine if it a risk factor for preterm birth
Maternal thrombocytopenia in pregnancy
Get PDFThrombocytopenia is a common occurrence in pregnancy. Although pregnancy is associated with physiological changes in platelet count, several pathological conditions cause thrombocytopenia, which can have a significant impact on the mother and the baby. There are diverse etiologies for thrombocytopenia, some of which are unique to pregnancy. This review provides a detailed discussion of the diagnosis and management of the various causes of thrombocytopenia in pregnancy.
Preeclampsia and MicroRNAs
Get PDFPreeclampsia is a critical gestational condition that threatens the life of both mother and child. One of the most serious aspects of preeclampsia hampering both clinical management and scientific understanding is that there are, as yet, no early warning signs or risk markers. The discovery of microRNAs (miRNAs), tiny post-transcriptional regulators of gene expression, offers potentially fertile ground for developing such markers. The current state of knowledge about miRNAs in preeclampsia is presented along with information regarding miRNA detection in peripheral fluids that could lead to minimally invasive risk assessment