Postmenopausal Tuberculosis Endometritis

Tuberculosis remains a global health problem, primarily in developing countries with inadequate health services. A significant portion of tuberculosis in these settings is extrapulmonary, including tuberculosis of the genitourinary tract. Patients with genital tuberculosis are usually young women detected during work up for infertility. After menopause, tuberculosis of the endometrium is a rare possibility probably because of the decreased vascularity of the tissues. We present a case of endometrial tuberculosis with postmenopausal vaginal bleeding

Different Surgical Techniques in Tubo-ovarian Abscess Management

Objectıve: Tubo-ovarian abscess is mostly a consequence of pelvic inflammatory disease. We aimed to compare success of the different surgical methods in tubo-ovarian abscess treatment. Study Design: 53 patients with Tubo-ovarian abscess that were hospitalized and operated in the Department of Obstetrics and Gynecology at Kanuni Sultan Suleyman Training and Research Hospital during one year were included. Patients who had underwent salpingectomy/salpingo-oophorectomy and only abscess drainage were compared. Results: Salpingectomy/salpingo-oophorectomy had been done in 74.5% of cases and only drainage had been applied in 25.5% of cases. Difference in mean values between 2 groups were not observed except white blood cell count. Conclusıon: Treatment of Tubo-ovarian abscess must be a combination of parenteral antibiotics and early surgical procedure to prevent poor outcomes. There is not any difference between different surgical techniques. But additionally more studies are needed to better understand which operation technique is more effective and less complicated

Partial HELLP syndrome: Maternal, perinatal, subsequent pregnancy and long-term maternal outcomes

WOS: 000333615200005PubMed: 24612188AimsHemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome, in its complete form, is associated with increased risk of maternal mortality and increased rate of serious obstetric complications, such as acute renal failure, hepatic failure, abruptio placentae, pulmonary edema, sepsis, hemorrhage and disseminated intravascular coagulopathy. To compare maternal and perinatal outcomes, we investigated the subsequent pregnancy outcomes and long-term complications of women with partial HELLP (pHELLP) and complete HELLP (cHELLP) syndromes. Material and MethodsIn this retrospective study, patients complicated with HELLP between the years 2002 and 2007 were analyzed. cHELLP syndrome was defined by the presence of all of the three laboratory criteria according to the Tennessee Classification System. pHELLP syndrome was defined by the presence of one or two features of HELLP, but not the complete form. ResultsSixty-four patients had cHELLP syndrome and 67 had pHELLP syndrome. Maternal complications and neonatal outcomes of the indexed pregnancies were similar. The rate of blood product transfusion was significantly higher in the cHELLP group (P<0.0001). Twenty-eight patients within the cHELLP group and 26 within the pHELLP group had subsequent pregnancies with a mean interpregnancy interval of 2.91.5 years and 2.4 +/- 1.1 years, respectively. Elective termination of pregnancy (dilatation and curettage) was more frequent in the cHELLP group. Pre-eclampsia recurrence was higher in the pHELLP group than in the cHELLP group (7.1% vs 34.6%). ConclusionsPartial and complete HELLP syndrome are not distinct groups based on neonatal, long-term and subsequent pregnancy outcomes. They probably represent a continuum in the natural evolution of the same disease

Do we protect the pelvic floor with non-elective cesarean? A study of 3-D/4-D pelvic floor ultrasound immediately after delivery

WOS: 000333615200020PubMed: 24612399AimTo compare levator defect, loss of tenting, change in biometric measurements of the levator ani and genital hiatus according to the mode of delivery, length of the labor, Bishop score, birthweight and head circumference immediately after delivery. MethodsOne hundred and seventy-one primiparous women who delivered either by vaginal delivery or cesarean were prospectively evaluated. Two 3-D volumes (one at rest, one on Valsalva maneuver) were recorded in the supine position after voiding, and levator biometry, levator defect and loss of tenting were determined on the axial plane. ResultsOf 171 nulliparous women, 84 had vaginal delivery and 87 had cesarean delivery. All hiatal dimensions on resting and maximal Valsalva were found to be higher in the vaginal delivery group. Levator defect rate was found to be significantly higher in the vaginal delivery group (P<0.0001). We found a positive correlation with head circumference, fetal weight and first stage labor length in women who delivered vaginally. In the cesarean delivery group, mean fetal head circumference, fetal weight, length of first stage of labor and Bishop score were higher in women with levator ani defect. Loss of tenting rate was significantly higher in vaginal delivery women (P=0.03). ConclusionLabor itself, and factors such as fetal head circumference and fetal weight that cause prolongation of labor, can induce levator ani muscle defect or microtrauma which in turn can cause morphological alterations of the levator hiatus

Different Surgical Techniques in Tubo-ovarian Abscess Management

Objectıve: Tubo-ovarian abscess is mostly a consequence of pelvic inflammatory disease. We aimed to compare success of the different surgical methods in tubo-ovarian abscess treatment. Study Design: 53 patients with Tubo-ovarian abscess that were hospitalized and operated in the Department of Obstetrics and Gynecology at Kanuni Sultan Suleyman Training and Research Hospital during one year were included. Patients who had underwent salpingectomy/salpingo-oophorectomy and only abscess drainage were compared. Results: Salpingectomy/salpingo-oophorectomy had been done in 74.5% of cases and only drainage had been applied in 25.5% of cases. Difference in mean values between 2 groups were not observed except white blood cell count. Conclusıon: Treatment of Tubo-ovarian abscess must be a combination of parenteral antibiotics and early surgical procedure to prevent poor outcomes. There is not any difference between different surgical techniques. But additionally more studies are needed to better understand which operation technique is more effective and less complicated