Proceedings in Obstetrics and Gynecology
Not a member yet
462 research outputs found
Sort by
Application of Bakri balloon in a patient who developed massive postpartum hemorrhage after caesarean section
Get PDFPostpartum hemorrhage is an important emergency in obstetrics. In this study, we present the application of intrauterine balloon tamponade and its outcomes in a patient who developed massive postpartum hemorrhage after caesarean section. A 39- year-old, G5 P3 and 38 weeks pregnant (based on last menstrual period) patient was subjected to emergency caesarean section due to diagnosis of uteroplacental insufficiency and recurrent caesarean section. Four hours after the operation, atony occurred and despite medical treatment the hemorrhage persisted. We inserted a SOS Bakri balloon through the vaginal route and inflated it with 500cc intracavitary saline for achievement of intrauterine tamponade. Vaginal bleeding ended immediately after the procedure. Use of an intrauterine balloon is an easy-to-apply alternative to surgery that provides rapid hemostasis in serious postpartum hemorrhage
Fetus papyraceous ın a twın pregnancy: a case report without any maternal and fetal complications.
Get PDFFetus papyraceous is defined as a compressed fetus, the mummified, parchment-like remains of a dead twin that is retained in-utero after intrauterine death in the second trimester. We report a case of fetus papyraceous (FP) in a diamniotic and dichorionic pregnancy with no maternal and fetal complications during pregnancy or the post-partum period
Evaluation of the VNTR region in the IDO promoter in women with preeclampsia
Get PDFIndoleamine 2,3 – dioxygenase (IDO) is an enzyme that aids in immunosuppression and tolerance. Previous studies have shown decreased IDO activity in pregnancies affected by preeclampsia, but the mechanism for this altered activity is unknown. Our study was designed to analyze the promoter region of IDO in preeclamptic and control women and identify the frequency of a VNTR genotype that has been shown to be significantly correlated with tryptophan levels in women; a surrogate marker for IDO activity
Coexistence of postpartum cardiomyopathy and single coronary artery anomaly
Get PDFPostpartum cardiomyopathy (PPCM) is dilated cardiomyopathy seen in the postpartum period in women who no prior history of cardiac diseases. In this case study, coronary angiography was used to determine the etiology of the cardiomyopathy after the decompensated heart failure had regressed. A congenital single coronary artery anomaly was detected by coronary angiography. In this case, PPCM can mimic pneumonia, thus making diagnosis difficult. When there is no response to antibiotic therapy, the obstetrician must consider cardiac disease and appropriate consultation should be obtained as soon as possible. To the best of our knowledge, single coronary artery anomalies coexisting with PPCM has only been documented in one other case in the literature. An association of single coronary artery anomalies with PPCM may be random, or, alternative, might contribute to the composition of the PPCM
Von Willebrand’s disease diagnosed after hemorrhage following hysteroscopic myoma resection and endometrial band excision
Get PDFVon Willebrand factor, the largest human plasma protein, is an adhesive multimeric glycoprotein that mediates platelet adhesion to both the subendothelial matrix and endothelial surfaces and acts as a carrier for coagulation factor VIII in the circulation. Von Willebrand disease (vWD) is the most common inherited bleeding condition that involves extended or excessive bleeding and is caused by the deficiency or defect of vWF. In this case report, we present vWD diagnosed after hemorrhage following hysteroscopic myoma resection and endometrial band excision. The importance of a detailed medical history is emphasized as even health care workers cannot spontaneously give this information. Further tests are recommended in patients who have a history of prolonged bleeding as bleeding time and other routine coagulation tests done preoperatively cannot always make a definite diagnosis
Pre-eclampsia and eclampsia: global challenges in low resource settings complete with proposed interventions in rural Haiti
Get PDFPreeclampsia is a complex multi-pathway disease process diagnosed by hypertension with two readings of systolic blood pressure ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, separated by a 4-6 hour period, and proteinuria with a urine dipstick of ≥ 1+ or ≥ 300 mg per 24 hours, after 20 weeks’ gestation in a previously normotensive patient. Ninety-nine percent of pregnancy related deaths occur in middle and low-income countries (LMIC). Of these deaths, the World Health Organization (WHO) ranks pre-eclampsia and eclampsia as the second leading direct cause of maternal morbidity and mortality, behind only postpartum hemorrhage. A woman born in a developing country has a seven times greater risk of developing pre-eclampsia and a three times greater risk of progressing to eclampsia. This paper seeks to review what we know about the basics of detection and management to encourage thoughtful applications in improving the global burden of pre-eclampsia and eclampsia in low resources settings
Investigation Parallels at University Hospitals: 1950-1975: The Departments of Urology and Obstetrics and Gynecology
Get PDFThe 1950’s was a period of notable intellectual growth and collaboration. During that period new isotopic elements evolved to new treatments for cancer patients, both women and men. The University of Iowa proved to be a fertile intellectual community where Gold 198 colloid successfully advanced survival for both ovarian and prostate cancer.Other collaboration expanded the fields of male and female infertility. Both departments benefit from this early pioneering work to the present day
Adnexal torsion in the first trimester of a spontaneous pregnancy: detorsion and oophoropexy
Get PDFIntroduction: Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. In this case report, we present a case of adnexal torsion during the first trimester of pregnancy and its treatment.Case Presentation: A 28-year old, gravida 1, para 0 patient at 9 weeks gestational age presented to the antenatal clinic with acute abdominal pain in the right lower-abdominal quadrant. The patient was diagnosed with torsion of the right adnexa during pregnancy, and detorsion was performed. The patient was followed throughout the course of pregnancy. She delivered a healthy baby at term by caesarian section. During the caesarian section, both of the adnexa were observed to be normal.Conclusions: With acute abdominal pain, especially in the lower-abdominal quadrant during pregnancy, adnexal pathologies should be considered. Diagnosis of adnexal torsion during the first trimester of pregnancy is often missed due to the nonspecific clinical features and uncommon objective findings. Although surgical intervention should be considered to treat pregnant women suffering from adnexal torsion regardless of the gestational week, abdominal surgery carries some risks to the pregnant woman and unborn fetus
Effect of chlorhexidine skin prep and subcuticular skin closure on post-operative infectious morbidity and wound complications following cesarean section
Get PDFBackground: The obstetrical department at University of Iowa implemented several interventions at reducing post-operative infections and wound complication rates following a cesarean delivery. We implemented subcuticular closure of the skin following all cesarean sections in February of 2011 and switched from a povidone/iodine skin prep to a chlorhexidine-alcohol prep April 19th 2011. Based on prior studies, we hypothesized a 50% reduction in post cesarean wound complicationsObjective:To determine if changes in skin prep type and closure method decreases post-operative infectious morbidity and wound complications.Methods:The study reviewed charts of women who underwent a cesarean section between 7/1/2010 and 12/31/2010 compared to those that underwent a cesarean section between 4/19/2011 and 9/7/2011. A total of 568 charts were reviewed. Women were divided into two groups; the control group included those who had a povidone/iodine skin prep and staple closure, the intervention group included those women who had chlorhexidine skin prep and skin closure with subcuticular suture.Results:A total of 568 charts were reviewed and 190 control (iodine/staples) subjects and 139 intervention (chlorhexidine-alcohol/suture) subjects were identified. We found no statistical difference in the overall wound complication rates between the control and intervention groups, 22.1% vs 17.4% (p.22). We did however find a significant decrease in wound separation rates: 8.4% vs 3% (p.014) Analysis showed significant risk factors for infectious morbidity and wound separation to be labor prior to surgery (pConclusion:In our population the implementation of a chlorhexidine skin prep and closure of the skin with a subcuticular suture did not decrease overall infectious morbidity, it did however decrease our wound separation rate
Uterus didelphys with multiple fibroids: A case report
Get PDFUterine anomalies are congenital malformations caused by fusion or resorption defects during embryogenesis. Uterus didelphys, or a double uterus, is a rare condition that occurs in female fetuses as they develop in the womb. Here we report a case of a 46 year old virginal female with uterus didelphys along with multiple fibroids of both uteri and a right ovarian cyst. The patient underwent a total abdominal hysterectomy with adnexa removal. The specimen showed leiomyoma of uterus with ovarian endometriosis