1/19. Cervical pregnancy--a conservative stepwise approach.A case of cervical pregnancy resistant to intramuscular methotrexate therapy is presented, which was successfully treated by intra-arterial methotrexate followed by selective prophylactic hypogastric artery embolization to avoid aggravating the vaginal bleeding. It is suggested that, in cervical pregnancies in which fertility preservation is desired, a stepwise conservative approach should be applied before resorting to surgical intervention.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/19. A cervical ectopic masquerading as a molar pregnancy.We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
3/19. Primary infertility associated with isolated cervical collecting diverticulum.OBJECTIVE: To describe a previously unreported isolated congenital cervical diverticulum and its gynecologic, reproductive, and obstetrical implications. DESIGN: Case report. SETTING: A university hospital. PATIENT: A 31-year-old woman presenting with menometrorrhagia and primary infertility. Investigation revealed an isolated collecting cervical diverticulum causing prolonged postmenstrual spotting, possibly interfering with sperm capacitation and access to the uterine cavity. INTERVENTION(S): The examination included hysterosalpingography and magnetic resonance imaging. The combined hysteroscopy and laparoscopy revealed a 5 x 5 cm cervical diverticulum, around 1 cm from the external cervical os, leading to a short cervical canal connected to a normal uterine cavity. The patient achieved a pregnancy after controlled ovarian hyperstimulation and ultrasonographically guided intrauterine insemination. MAIN OTUCOME MEASURE(S): pregnancy and obstetrical outcome. RESULT(S): Extensive evaluation revealed the patient's condition to be a previously undescribed congenital cervical anomaly. The patient's infertility was corrected by ovulation induction and sonographically guided intrauterine insemination, which resulted in a twin pregnancy. After 27 weeks of gestation, preterm labor complicated the delivery. CONCLUSION(S): The diagnosis and management of this unusual congenital cervical diverticulum present a particular challenge, as this congenital abnormality has not been previously described or reported.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
4/19. Cervico-vaginal fistula from induced abortions causing subsequent spontaneous midtrimester abortions in Nigerians: case report.A report of three cases of cervico-vaginal fistula (CVF) from induced abortions causing subsequent spontaneous mid-trimester abortions and a literature review is presented. Restrictive abortion laws, low contraceptive usage and increased sexual activity consequent upon adverse socio-economic conditions have led to an increase in the prevalence of illegal abortions in nigeria over the previous two decades. CVF appears to be an emerging complication of such abortions. Cervical cerclage is preferred to trachelorrhaphy in the management of such cases. However, where vaginally performed cerclage does not succeed, the abdominal route should be used as a last resort. After a previous induced abortion, clinicians managing the subsequent pregnancy need to search carefully for cervico-vaginal fistula, which may compromise that particular pregnancy. Appropriate contraceptive use and safe abortions using modern methods in cases of contraceptive failure will prevent such horrendous complications of induced abortions in nigeria and other developing countries.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
5/19. Pathogenesis of microglandular hyperplasia of the cervix uteri.Microglandular hyperplasia of the cervix has commonly been associated with pregnancy and oral contraceptive use. In a review of 22 cases seen over the last 10 years, 6 of the cases were not associated with hormonal changes. The idiopathic presentation of this lesion is reviewed. Microglandular hyperplasia of the cervix mimicking clear cell carcinoma of the cervix occurred in a 26-year-old woman with a history of in utero stilbestrol exposure who was taking an oral contraceptive. The differentiation of these two unusual lesions of the cervix is discussed.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
6/19. Cervical pregnancy. Case report and literature review.Cervical pregnancy is an uncommon life threatening form of ectopic pregnancy that is associated with the unexpected occurrence of uncontrollable haemorrhage from the cervix. To avoid hysterectomy and to maintain fertility, several conservative methods of termination have been used. We present herein, one such case which relates to a young woman who had successful conservative management of a cervical pregnancy using vasopressin infiltration of the cervix, a McDonald cerclage and cervical curettage followed by balloon tamponade. Subsequently, she became pregnant again with a normal intra-uterine pregnancy and had a successful vaginal delivery.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
7/19. Arias-Stella reaction of the endocervix: a report of 18 cases with emphasis on its varied histology and differential diagnosis.We report 18 cases of Arias-Stella reaction involving the endocervix with an emphasis on histologic features that can be encountered and result in the misdiagnosis of carcinoma. The patients ranged in age from 19 to 44 years. Two patients had a history of oral contraceptive use and 15 were pregnant; clinical information was not available in one case. Ten lesions presented as cervical polyps, and six were incidental findings in specimens obtained because of cervical dysplasia, dysfunctional uterine bleeding, fibroids, and a missed abortion. One patient was found to have a cervical "lesion" on a routine gynecologic examination. In the remaining patient, a cervical biopsy was obtained, for unknown reasons, at the time of termination of pregnancy. Microscopic examination showed a varied histologic appearance including vacuolated clear cytoplasm (18 cases), intraglandular tufts (16 cases), hobnail cells (14 cases), oxyphilic cytoplasm (13 cases), delicate filiform papillae (12 cases), intranuclear pseudoinclusions (10 cases), cribriform intraglandular growth (3 cases), and a single mitotic figure in 1 case. The histologic changes involved the superficial glands (6 cases), deep glands (4 cases), or both (8 cases); confluent or extensive gland involvement was seen in 8 cases. Follow-up information, available in four cases (4, 2, 1, 1 years), was unremarkable. The principal consideration in the differential diagnosis was clear cell carcinoma. The features most helpful in this distinction were the usual lack of a mass suspicious for cancer, absence of a desmoplastic response, lack of an infiltrative pattern, spectrum of cytologic atypia, low nuclear-cytoplasmic ratio, and usual lack of mitotic activity.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
8/19. Cervical stenosis in pregnancy: a complication of cryotherapy in diethylstilbestrol-exposed women.cryotherapy causes a high incidence of cervical stenosis in diethylstilbestrol-exposed women because of an abnormal healing response. Consequently, the cervix may not dilate during labor, necessitating cesarean section. To prevent this, therapy should be localized to the abnormal tissue on the cervix instead of the entire transformation zone whenever possible.- - - - - - - - - - ranking = 0.8keywords = pregnancy (Clic here for more details about this article) |
9/19. Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series.The course of the transfer catheter through the cervical canal is one of the most important issues for a successful embryo transfer (ET) during in vitro fertilization (IVF) cycles. Technically difficult ETs due to cervical stenosis are associated with reduced chance of pregnancy after assisted reproductive procedures. In the current case series, we report on three patients with cervical stenosis who underwent IVF-ET cycles. These three patients, in whom ET was classified as "difficult," failed to conceive with previous ET attempts. An intervention to create a cervical tract was performed with operative hysteroscopy under general anesthesia before transcervical ET. After the hysteroscopic shaving procedure, we observed quite an improvement in access to the endometrial cavity during ET procedure. These patients had significantly easier ET procedures compared with previous attempts and achieved clinical pregnancies. Hysteroscopic revision of the cervical canal results in easier ET and improves pregnancy rates in patients with cervical stenosis and histories of difficult ET.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
10/19. Severe cervical stenosis with the twin-to-twin transfusion syndrome.The twin-to-twin transfusion syndrome and severe cervical stenosis are two unusual complications of pregnancy. I have presented a case in which both complications were additive in their adverse effects on the pregnancy.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
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