11/182. uterine rupture during pregnancy following myomectomy via coelioscopy.A 33-year-old woman underwent a myomectomy via coelioscopy and then showed 5 years later a uterine rupture at the 32nd week of amenorrhea. The rupture was diagnosed after the echography, while there was no peritoneal maternal patency nor foetal consequence. After a cesarean and an uterine repair, the recovery of the mother was satisfactory but the newborn was to die at the 6th week of life. This obstetrical complication raises the problem of myomectomy via coelioscopy in young women, whose indications are being discussed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
12/182. Anaesthesia for caesarean section in a patient with Eisenmenger's syndrome.Eisenmenger's syndrome was originally described in 1897 and redefined by wood in 1958. This syndrome includes pulmonary hypertension with reversed or bi-directional shunt associated with septal defects or a patent ductus arteriosus. A 27-year-old G2 PO with Eisenmenger's syndrome presented to the hospital for management at 17 weeks of pregnancy. She was advised termination of pregnancy but she refused. An elective caesarean section was performed successfully under general anaesthesia uneventfully at 29 weeks due to severe intrauterine growth retardation (IUGR). Patient's postoperative complications like pulmonary thromboembolism, the advantages and disadvantages of anticoagulation are discussed. pregnancy carries substantial maternal and fetal risk for patients with pulmonary hypertension and Eisenmenger's syndrome. Although pregnancy should be discouraged in women with Eisenmenger's syndrome it can be successful.- - - - - - - - - - ranking = 0.75keywords = pregnancy (Clic here for more details about this article) |
13/182. arteriovenous malformations of the uterus associated with medical abortion.Seven cases of uterine arteriovenous malformations associated with pregnancy were initially suspected by the history of prolonged bleeding after a medical abortion and then confirmed by color Doppler scanning. All cases were managed expectantly and resolved spontaneously. When AVMs required diagnosis by pathology or angiography, only the most severe cases would have been reported. Now that they can be recognized on ultrasound, it is possible that mild cases such as these will be found to be much more common.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
14/182. Spontaneous second trimester uterine rupture after classical cesarean.BACKGROUND: Several cases of spontaneous second trimester uterine rupture have been reported, but none as early as 15 weeks' gestation after classical cesarean and with placenta percreta. CASE: A 23-year-old woman, gravida 5, para 3, at 15 37 weeks' gestation with a history of classical cesarean incision presented to the emergency department with abdominal pain, hypotension, and tachycardia. Ultrasound showed a normal intrauterine pregnancy. She developed worsening pain, abdominal rebound, and abdominal distention. On exploratory laparotomy, a large uterine rupture was found and hysterectomy was done. CONCLUSION: Spontaneous uterine rupture after classical cesarean can occur as early as 15 weeks' gestation. uterine rupture must be considered in differential diagnoses of severe abdominal pain even in the early second trimester.- - - - - - - - - - ranking = 0.42659552159376keywords = pregnancy, gestation (Clic here for more details about this article) |
15/182. uterine rupture in pregnancy subsequent to previous laparoscopic electromyolysis. Case report and review of the literature.Reports about uterine rupture in pregnancy subsequent to previous laparoscopic surgery are not frequent. This may be due to the lack of long term follow up of patients who had undergone this surgery rather than the rarity of this complication. A case of uterine rupture subsequent to laparoscopic myomectomy is reported. An increasing rate of the occurrence of this complication is reviewed in current literature, thus reiterating the need for more stringent selection criteria for patients who benefit from this surgical technique.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |
16/182. Postcesarean small bowel volvulus. Case report and review of the literature.Volvulus is an uncommon cause of bowel obstruction during pregnancy. We present an unusual case in which cesarean delivery at 26 weeks of gestation was complicated by volvulus of the small bowel 1 week following delivery. At laparotomy, detorsion of the loop of the terminal ileum sufficed, and bowel resection was not required. We review the literature pertaining to volvulus of the bowel during pregnancy and discuss recent new diagnostic imaging modalities for midgut volvulus, which may assist early noninvasive diagnosis of this condition.- - - - - - - - - - ranking = 0.55886517386459keywords = pregnancy, gestation (Clic here for more details about this article) |
17/182. Surgery for lumbar disc herniation during pregnancy.STUDY DESIGN: The case reports of three pregnant patients with lumbar disc herniation causing cauda equina syndrome or severe neurologic deficits are presented to illustrate that disc surgery during gestation is a safe method of management. OBJECTIVE: To emphasize the importance of recognizing and definitively treating lumbar disc displacement causing neurologic deficits during pregnancy. SUMMARY OF BACKGROUND DATA: The advent of magnetic resonance imaging and modern surgical techniques for treatment of lumbar disc displacement allows safe management of this condition at any stage of gestation. A review of the literature on the risks of nonobstetric surgery and the risks of delaying disc surgery until delivery shows that operating at any stage during gestation for severe neurologic deficit secondary to lumbar disc displacement is justified. methods: A review of the literature on the use of magnetic resonance imaging scan and nonobstetric surgery during pregnancy was performed. Three case reports of the authors' patients who had lumbar disc displacement with cauda equina syndrome or severe neurologic deficit are presented. patients were placed prone on a four-poster frame, and an epidural anesthetic agent was administered. A one-level hemilaminectomy, partial facetectomy, and disc excision were performed in all three cases. RESULTS: The methods used for diagnosis and surgical treatment of three patients with disc herniation during pregnancy resulted in a satisfactory outcome for both mother and child. The medical literature supports surgical intervention in pregnant patients with cauda equina syndrome and severe and/or progressive neurologic deficit(s) from lumbar disc displacement at any state of gestation. CONCLUSION: Although extremely rare, cauda equina syndrome and severe and/or progressive neurologic deficit caused by lumbar disc displacement can occur during pregnancy. The prevalence of symptomatic lumbar disc herniation during pregnancy may be on the increase because of the increasing age of patients who are becoming pregnant. These cases showed, and the literature confirms, that pregnancy at any stage is no contraindication to magnetic resonance imaging scan, epidural and/or general anesthesia, and surgical disc excision.- - - - - - - - - - ranking = 2.7354606954583keywords = pregnancy, gestation (Clic here for more details about this article) |
18/182. In-utero treatment of fetal bladder-outlet obstruction by a ureterocele.Fetal bladder-outlet obstruction by ureteroceles is usually treated at birth. However, such obstruction may be detrimental to the health of the fetus and so in-utero correction is preferable. We describe the successful cytoscopy guided laser incision, with no complications, of a uterocele that was causing bladder-outlet obstruction in a fetus of 19 weeks and 6 days gestation.- - - - - - - - - - ranking = 0.058865173864587keywords = gestation (Clic here for more details about this article) |
19/182. pregnancy complicated by a suburethral sling: a case report.Incontinence surgery is rarely performed prior to the completion of a woman's childbearing. The literature is sparse in regard to women with prior incontinence surgery. There are no reports of pregnancy complicated by a sling procedure. A 26-year-old gravida 3, para 2-0-0-2 with prior surgical history of a Pereyra urethropexy followed by a Vesica suburethral sling, was referred at 18 weeks' gestation for assessment of the sling. Her antenatal course was complicated by pyelonephritis and intermittent urethral obstruction requiring Foley catheter placement. She delivered by scheduled cesarean section at 37 weeks' gestation. Three months following delivery she presented with pyelonephritis and recurrence of her incontinence. pregnancy complicated by prior suburethral sling procedure may result in urinary outlet obstruction, pyelonephritis and disruption of the surgical repair.- - - - - - - - - - ranking = 0.36773034772917keywords = pregnancy, gestation (Clic here for more details about this article) |
20/182. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation and subsequent pregnancy in the treatment of early invasive cervical cancer.BACKGROUND: Recently, pregnancies in patients after radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy have been reported. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation has been previously described; however, subsequent outcome and pregnancy has not. methods: Three patients with cervical carcinoma, 1 with stage IA1 with lymph-vascular space invasion and 2 with stage IA2, were treated with radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation. RESULTS: All patients underwent the planned procedure with no significant intraoperative or postoperative complications. All patients had return to normal menstrual function. One patient had a successful pregnancy delivered at 39 weeks by cesarean section and is now subsequently pregnant with a second pregnancy. CONCLUSION: Radical abdominal trachelectomy is a technically feasible operation that uses operative techniques familiar to the American-trained gynecologic oncologist and results in wider parametrial resection than radical vaginal trachelectomy. In young patients desiring to retain fertility, successful pregnancies after radical abdominal trachelectomy are possible. Intraoperative and postoperative complications are likely to be lower with an abdominal versus a vaginal approach. Long-term survival of patients treated with radical trachelectomy for early invasive cervical cancer are yet to be determined.- - - - - - - - - - ranking = 1.75keywords = pregnancy (Clic here for more details about this article) |
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