1,721,002 research outputs found
Adenomyosis in a patient with mosaic Turner's syndrome.
No full textBACKGROUND: Adenomyosis typically affects multiparous women be- tween the ages of 35 and 50, who present with painful irregular periods or excessive menstrual bleeding. Few case reports describing endometriosis in patients with gonadal dysgenesis have been published, but none has reported the presence of adenomyosis in a patient with Turner's syndrome.
CASE: A 31-year-old woman with mosaic Turner's Syndrome was referred to us because of severe iron deficiency anaemia due to hypermenorrhea and persistent lower abdominal pain for more than six months. The karyotype analysis on peripheral blood lymphocytes confirmed the mosaic Turner’s syndrome: 45,X (96% cells), 46,XX (2% cells) and 47,XXX (2% cells). She presented normal secondary sex development, normal breast, normal pubic and axillary hair. The external genitalia were also normal. Laboratory examination showed normal gonadotropin, 17beta-estradiol, plasma androgens and cortisol levels. At transabdominal ultrasound a myoma (15 x 8.5 x 8 cm) arising from the posterior uterine wall was suspected. The mass was removed during laparotomy. Histologic examination confirmed the presence of the myoma and revealed the presence of focal adenomyosis: a circumscribed nodular aggregate of endometrium-like tissues containing both surface epithelium and stroma was detected as deep as one-third of the total myometrial thickness.
CONCLUSION: Adenomyosis and leiomyomata are separate entities but they share a common pathology in that they develop primarily in women of reproductive age and their growth is oestrogen dependent. To our knowledge, this is the first case report in the literature of adenomyosis in a woman who had the Turner's syndrome
Post-operative complications after caesarean section in HIV-infected women.
No full textThis retrospective study evaluated complications associated with caesarean section in HIV-infected women. For each HIV-positive patient ( n=45) a control group of ten seronegative women ( n=450) was matched for age, number of foetuses, gestational age, indication for caesarean section, status of the membranes and kind of anaesthesia. All women delivered in the same hospital using a uniform protocol. We evaluated the duration of stay in hospital after operation, the need for antibiotics after caesarean section, the incidence of minor postoperative complications (mild anaemia, mild temperature or fever 24 h after surgery, wound haematoma or infection, urinary tract infection, endometritis) and major postoperative complications (severe anaemia, pneumonia, pleural effusion, peritonitis, sepsis, disseminated intravascular coagulation, thromboembolism). Most HIV-positive women (64.5%) had a complicated recovery after surgery. A higher incidence of major and minor postoperative complications were observed in the HIV-positive group than in the control group. There was a statistically significant greater incidence of mild anaemia, mild temperature or fever, urinary tract infection and pneumonia in the HIV-positive group. HIV-positive women with less than 500x10(6) CD4(+) lymphocytest/l had higher post-caesarean section morbidity than HIV-positive women with more than 500x10(6) CD4(+) lymphocytest/l. The median duration of hospital stay was significantly higher in the HIV-positive group (median 7 days) than in the HIV-negative group (median 4 days). The rate of HIV vertical transmission was 8.8%. Higher post-caesarean section morbidity was found in HIV-positive women than in controls. Unfortunately, the HIV-positive women (with low CD4 lymphocytes counts), whose infants theoretically will benefit most from caesarean delivery, are also the women who are most likely to experience post-operative complications
Seventy-five ectopic pregnancies. Medical and surgical management.
No full textBackground. The aim of this study was to evaluate the treatment options of ectopic pregnancy. Methods. Retrospective analysis performed on 75 patients diagnosed and hospitalised with ectopic pregnancy from January 1996 to May 2001. The medical records of each patient were evaluated. Results. Treatment options: immediate surgical treatment (44%), methotrexate (MTX) therapy (43%) and expectant management (13%). MTX therapy success rate was 78.1%. Laparotomy was performed in 52.5% of surgically treated women. Over time there was an increase in the use of laparoscopic surgery: 75% of women underwent laparoscopy in the period 2000-2001. The rate of laparotomy still remains higher than the rate previously reported in other studies; the reason is that in our hospital no equipment for laparoscopy is available for emergency condition. Expectant management was effective when there was no pain and serum hCG levels were constantly low or were decreasing. Conclusions. Technological advances allow diagnosis of ectopic pregnancy before severe clinical symptoms arise. Although early diagnosis may contribute to higher incidence, it has also contributed to a decline in morbidity, deaths, and treatment costs. Timely and early diagnosis has made this disorder amenable to medical therapy, with success rates similar to those of traditional surgical treatment. Surgery is preferred when there are tubal ruptures or a high potential for rupture, hypotension, anaemia or ectopic pregnancy which is larger than 3 cm in diameter
Increased incidence of infective post-operative complications after caesarean section in HIV-infected women
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Screening e trattamento della displasia cervicale intraepiteliale (CIN) nelle donne HIV-positive
No full textPeripartum cardiomyopathy.
No full textAccording to current definition, peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the last month of pregnancy. It has been reported that the incidence of PPCM is 1 in 3,000-4,000 live births. The pathogenesis is poorly understood, however, infectious, immunologic, and nutritional causes have been hypothesized. Clinical presentation includes usual signs and symptoms of heart failure, and unusual presentations such as thromboembolism. Diagnosis is based upon the clinical presentation of congestive heart failure and the objective evidence of left ventricular systolic dysfunction. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Patients with systolic dysfunction during pregnancy are treated similar to patients who are not pregnant. The mainstays of medical therapy are digoxin, loop diuretics, sodium restriction and afterload reducing agents (hydralazine and nitrates). Due to a high risk for venous and arterial thrombosis, anticoagulation with subcutaneous heparin should be instituted. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy because of severe adverse neonatal effects. Effective treatment reduces mortality rates and increases the number of women who fully recover left ventricular systolic function. The prognosis is poor in patients with persistent cardiomyopathy. Subsequent pregnancies are often associated with recurrence of left ventricular systolic dysfunction
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