1/13. urinary retention during the second trimester of pregnancy: a rare cause.Acute urinary retention during pregnancy is rare. Retention secondary to an impacted, gravid uterus is an emergency. Retroversion of the uterus, a history of pelvic inflammatory disease, and large fibroids are predisposing factors. The enlarging gravid uterus and uterine fibroids may trap the uterus inside the pelvic ring, preventing it from ascending into the abdominal cavity; furthermore, a history of inflammatory disease may trap the fundus of the uterus within scar tissue that also may prevent the enlarging, gravid uterus from ascending into the abdominal cavity. The impacted uterus should be manually replaced in the anterior position. Clean intermittent catheterization and placement of a vaginal pessary are temporizing measures. A knowledge of the causes of urinary retention during pregnancy can help prevent spontaneous abortion and other devastating consequences that can arise as a result of a delay in the diagnosis.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
2/13. Durability of the Malone antegrade continence enema in pregnancy.The Malone antegrade continence enema (MACE) is a therapeutic option to treat chronic constipation and fecal incontinence in patients with neurogenic bowel. Previous reports have described the short-term success of this procedure, but no report has described the durability of the procedure during pregnancy. We present the case of a spinal cord injury patient who underwent an uncomplicated pregnancy after a MACE procedure with no stomal catheterization difficulties or leakage during or after the pregnancy.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
3/13. Acute myocardial infarction during pregnancy.We describe the case of a 27-year-old primigravida with an unremarkable medical history and no risk factors for coronary artery disease. At 28 weeks she received tocolytic therapy, first with ritodrine, subsequently with nifedipine for preterm labour. In addition she developed an uncomplicated non-Q wave anterolateral myocardial infarction. A coronary angiography performed 2 days after the acute event was normal. The further course was uneventful with a spontaneous vaginal delivery at 40 weeks. We reviewed the literature concerning the incidence of acute myocardial infarction during pregnancy, its physiologic backgrounds and the possible association with use of tocolytic therapy, sympathomimetic agents in particular. The impact of pregnancy on maternal haemodynamics is generally underestimated, which makes an early diagnosis often difficult. Future research has to define the specific role of currently available treatment options, including cardiac catheterization and more recently developed pharmacologic interventions. Obviously, foetal considerations will greatly influence the selection of different approaches.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
4/13. Incarceration of a retroflexed, gravid uterus from severe uterine prolapse: a case report.BACKGROUND: Acute urinary retention as a result of incarceration of a retroflexed, gravid uterus is a known phenomenon. However, prolapse as a risk factor has not been previously described. CASE: A 40-year-old woman, gravida 4, para 2, with an intrauterine gestation of 19 weeks presented to the emergency room complaining of inability to void for the previous 12 hours and difficulty voiding and constipation for the previous 6 weeks. She had a history significant for stage III uterine prolapse in early pregnancy. Foley catheterization yielded 800 mL of urine, and an examination revealed a retroflexed uterus. The cervix was displaced anteriorly behind the pubic symphysis. Ultrasound confirmed these findings and the presence of a viable gestation. The uterus was successfully manually displaced under epidural anesthesia. The patient was able to void without difficulty after uterine displacement. CONCLUSION: Incarceration of a retroflexed uterus should be considered in the differential diagnosis in any woman who presents with voiding difficulty in the late first or second trimester. uterine prolapse is a risk factor for incarceration of a retroflexed uterus. Epidural anesthesia should be considered for a patient if manual uterine displacement cannot be performed successfully without anesthesia.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
5/13. pregnancy in a woman with severe pulmonary fibrosis secondary to hard metal disease.The effect of interstitial pulmonary fibrosis on pregnancy is unclear. We present the findings in a 31-year-old woman with severe pulmonary fibrosis (vital capacity, 37 percent of predicted) secondary to hard metal disease who went through a successful term pregnancy. The patient was a grinder of tungsten-carbide drill bits who developed pneumonitis and subsequent fibrosis. Her therapy required steroids and cyclophosphamide for stabilization of her pulmonary function prior to her pregnancy. At six months' gestation, right heart catheterization showed normal cardiac output and pulmonary arterial and wedge pressures. Stage 2 exercise study demonstrated a maximum oxygen consumption of 1.17 L/min (53 percent of predicted). The patient was able to exercise to a maximum workload of 300 kpm/min (32 percent of predicted). She became hypoxemic (arterial oxygen pressure, 54 mm Hg) at 150 kpm/min. Her pregnancy concluded with an uncomplicated normal vaginal delivery requiring only supplemental oxygen and spinal anesthesia. review of the few similar cases suggests that a woman can have a successful pregnancy despite severe pulmonary dysfunction.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
6/13. Percutaneous nephrostomy for treatment of hydronephrosis of pregnancy.hydronephrosis of pregnancy is a common phenomenon that rarely requires invasive intervention. We describe a young woman with markedly obstructive hydronephrosis of pregnancy causing forniceal extravasation who was treated successfully by percutaneous nephrostomy. The rationale of such intervention and its advantages over retrograde ureteral catheterization or stenting are discussed.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
7/13. Retroverted impacted gravid uterus with acute urinary retention: report of two cases and a review of the literature.Two cases of acute urinary retention in association with a retroverted impacted gravid uterus are described. Manual replacement of the uterus into an anterior position resolved the urinary retention in both cases. A review of the literature for retroverted impacted gravid uterus and related disorders is given. Successful treatment of retroverted impacted gravid uterus can usually be performed by initial bladder catheterization followed by manual replacement of the uterus, or by chronic bladder drainage until the uterus ascends out of the pelvis.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
8/13. Hirschsprung's disease discordant in monozygotic twins: a study of possible environmental factors in the production of colonic aganglionosis.The occurrence of Hirschsprung's disease, with histologically verified colonic aganglionosis, in only 1 of 2 prematurely born and presumed identical (monozygotic) twins is reported. The occurrence of monozygotic twinning was supported by the observed sharing of a single and common placenta and by ABO and HLA identity of peripheral blood erythrocytes and leukocytes. The affected twin was of a slightly lower birth weight and experienced early respiratory distress, necrotizing enterocolotis, and more prolonged umbilical artery catheterization (no encountered in the unaffected twin). This, to the authors' knowledge, is the first reported occurrence of Hirschsprung's disease discordant in monozygotic twins. The literature relating to genetic and environmental factors in clinical and experimental colonic aganglionosis is reviewed and speculation is presented regarding the occurrence of colonic aganglionosis discordant in monozygotic twins as reported here.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
9/13. A sertoli-leydig cell tumor and pregnancy. Clinical, endocrine, radiologic, and electron microscopic findings.An extremely rare case of a conception occurring in a 26-year-old patient with a small virilizing sertoli-leydig cell tumor (diameter: 0.6 cm), bilateral polycystic ovaries and non-tumorous adrenal hyperandrogenism is presented. Prepregnancy findings included hirsutism, clitoromegaly, secondary amenorrhea, and elevated peripheral plasma testosterone (T; 5.7 ng/ml). Extensive basal steroid screening, dynamic function tests, conventional radiologic procedures, selective glandular vein catheterization, and laparoscopy failed to localize unequivocally the source of androgen excess, but suggested bilateral adrenal involvement. The patient conceived during the diagnostic work-up; peripheral T levels increased to 12.1 ng/ml within the first trimester. An exploratory laparotomy with left adrenalectomy, right adrenal biopsy and left ovarian wedge resection revealed an incompletely removed sertoli-leydig cell tumor, but normal adrenal histology. The pregnancy was terminated, a left oophorectomy and right ovarian wedge resection were performed at 14 weeks' gestation. Subsequently, peripheral androgens returned to normal, regular menses resumed, and hirsutism disappeared. Three years later the patient delivered a healthy female infant.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
10/13. cardiac catheterization under echocardiographic control in a pregnant woman.A 22 year old woman had signs of rheumatic mitral and aortic valve disease early in pregnancy. cardiac catheterization was performed during her third month of pregnancy under two-dimensional echocardiographic control without the use of ionizing radiation. Severe mitral stenosis with mild aortic stenosis was found. Five cubic centimeters of 5 percent dextrose in water were injected by hand to obtain left ventriculograms and supravalvular aortograms of sufficient quality to diagnose valvular regurgitation. The use of "echo-catheterization" may have significant advantages in selected clinical situations.- - - - - - - - - - ranking = 6keywords = catheterization (Clic here for more details about this article) |
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