1/4. Intermenstrual bleeding secondary to cesarean scar diverticuli: report of three cases.BACKGROUND: The differential diagnosis of intermenstrual bleeding includes structural lesions of the endometrium and cervix. CASES: Discrete diverticuli were noted in the endocervical canals of three women presenting with histories of multiple cesareans and chief complaints of intermenstrual bleeding. On ultrasound, diverticuli were diagnosed as cavities filled with heterogeneous material consistent with blood. In one case, the diverticulum was also visualized on hysterosalpingogram. hysterectomy specimens in two cases showed diverticuli lined with fibrous tissue in previous uterine scars; in one case, this also contained endometrium. CONCLUSION: Uterine scar diverticuli may cause intermenstrual bleeding in women with previous cesareans. When performing ultrasound in this clinical setting, physicians should look for these defects.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Symptoms associated with menstruation.Symptoms associated with menstruation during the teenage and young adult years may represent a spectrum of possibilities varying from a relatively benign deviation from normal to a serious life-threatening disease. Nevertheless, even for the young woman found to be without serious disease, menstrual problems have special meaning associated with the fear of being different from peers, concern about being less than complete or wholesome, and anxiety regarding future functioning as a normal woman. The physician must be aware of the adolescent's sensitivity in this area. Her apprehension should influence the manner in which the various abnormalities of menstruation are evaluated and managed. The physician must understand and appreciate the potential for profound emotional effects and psychological implications of menstrual conditions. The manner in which we care for the adolescent with menstrual symptoms will determine to a significant degree how successfully the patient will cope with abnormalities of menstruation.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
3/4. exercise-induced menstrual irregularities.exercise of sufficient rigor, particularly when coupled by weight loss and dietary restriction, is capable of producing reversible disturbances of reproductive function in many otherwise healthy women. However, it is clear that there are many health benefits for women who exercise regularly and in moderation. These include improved cardiovascular status, increased bone mineral content, improvement of dysmenorrhea and premenstrual syndrome symptoms, and general stress reduction. In addition, the inclusion of young women in high school and college athletics has provided many new opportunities. With these new opportunities, however, have come new challenges for physicians in assisting these women in maintaining optimal health.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Subclinical spontaneous abortion.blood samples were obtained from 5 women during the menstrual cycle in which they had conceived. Although neither the women nor their physicians were clinically aware that conception had occurred, one or more of the blood specimens from each woman contained human chorionic gonadotropin (hCG), as measured by a specific radioimmunoassay. Each patient underwent a spontaneous abortion with 4 of the 5 women describing a delayed, but otherwise normal, menses. The fifth noted an unusually abundant amount of vaginal bleeding. Immunologic urinary pregnancy slide tests were negative in the 4 women on whom the tests were performed. The levels of hCG in the serum of these women were abnormally low for the estimated length of gestation, suggesting that defective trophoblastic function may be important in the pathogenesis of this phenomenon. These examples illustrate that some women may conceive and abort so early that the pregnancy and the abortion may remain subclinical. Therefore, it is likely that the true incidence of spontaneous abortions during the first trimester is greater than the presently accepted incidence of 15%.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |