Vaginal Prolapse of a Myoma After Cesarean Section

Uterin fibroidler (UF) premenopozal dönemdeki kadınlarda en yaygın görülen jinekolojik tümörlerdir. Günümüzde kadınların çocuk sahibi olma isteklerini 30 yaş sonrasına ertelemeleri nedeniyle gebelikte miyom saptanma sıklığı geçmişe oranla artış göstermektedir. Gebelikte myom saptanan kadınların büyük kısmı herhangi bir sorun yaşamadan gebeliklerini sonlandırmaktadır, ancak literatürde miyomlar; spontan düşük, erken eylem, ablasyo plasenta, erken membran rüptürü, fetal malprezantasyon, distosi, sezaryen ile doğum, postpartum kanama ve histerektomi ile ilişkili bulunmuştur. Bu olgu sunumunda, gebeliğinde fundal bölgede, servikal bölgede, uterus posteriorunda birden fazla myom olan hastanın gebelik takibinde myom dejenerasyonuna bağlı ağrı dışında komplikasyonu olmamıştır. Servikal bölgedeki yaklaşık 8 cm'lik myom nedeniyle hasta sezaryen ile doğumu gerçekleştirilmiştir. Sezaryende hastanın myomlarına müdahale edilmemiştir. Post-operatif 2. günde taburcu edilen hasta, postoperatif 15. günde vajinal kanama nedeniyle kliniğimize başvurmuştur. Hastanın vajinal muayenesinde serviksi dilate eden vajene doğmuş yaklaşık 5-6 cm'lik, plasental kalıntıyı andıran, dejenere miyom saptanmıştır. Genel anestezi altında myom vajinal yolla ekstirpe edilmiştir. İşlem sonrası kanaması olmayan hasta postoperatif 1. günde taburcu edilmiştir.Uterine fibroids (UF) are the most common gynecological tumors in women during premenopausal period. For the last decade women tend to delay childbearing after the age of 30 which leads to greater number of pregnancies with uterine fibroids. Although most of the pregnancies reach term without adverse events, it is clearly known that uterine fibroids are associated with a high risk of spontaneous miscarriage, preterm labor, placental abruption, premature rupture of membranes,fetal malpresentation, labor dystocia, cesarean delivery, postpartum hemorrhage and hysterectomy. in this case report; we present a woman who had an 8 cm- intramural myoma located at the posterior wall of the uterus during pregnancy. At the postoperative 15th day she presented with vaginal bleeding. on gynecological examination, an approximately 6 cm heterogen mass mimicking placental rest material which prolapsed to vagina was determined. This mass extirpated from uterine cervix and sent for pathological examination which was reported as degenerated uterine fibroid material. the patient was discharged from the hospital in the following day

RUPTURED CORNUAL HETEROTOPIC PREGNANCY AFTER IN VITRO FERTILIZATION AND EMBRYO TRANSFER: A CASE REPORT

Heterotopic pregnancy, characterized by the condition of coexisting intrauterine and extrauterine pregnancy, until recently, was considered to be a rare event occurring once in every 30000 cases. Herein, we report a case of ruptured cornual pregnancy, coexisting intrauterine pregnancy, diagnosed during 11th week of in vitro fertilization (IVF) pregnancy who was on hemorrhagic shock and successfully managed by cornual repairment and salpingectomy.Heterotropik gebelik, 30 000 vakada bir görülen, ekstrauterin gebeliğin intrauterine gebeliğe eşlik ettiği nadir görülen bir durumdur. Olgumuzda, rupture kornual gebeliğe, intrauterine gebelik eşlik etmektedir. Heterotropik gebelik tanısı, 11.gebelik haftasında ve hemorojik şok tablosunda iken konulmuştur. Tedavisi salfenjektomi ve kornual onarımla başarı ile yapılmıştır

Maternal Aspects of Preeclampsia

Preeclampsia is almost exclusively a disorder of human pregnancy, the pathogenesis of which remains unknown. Preeclampsia affects 3 to 8% of all pregnancies and still remains a leading cause of maternal morbidity and mortality. Because of the defective uteroplacental unit associated with preeclampsia; adverse fetal, neonatal events usually observed in these cases. the adverse effects of preeclampsia on the maternal hematologic, cardiovascular and pulmonary, neurologic, renal, and gastrointestinal system are also important. the aim of this review is to underline the maternal adverse effects of preeclampsia.Preeklampsia yalnızca insan gebeliğinde görülen bir hastalıktır, patogenezi bilinmemektedir. Tüm gebeliklerin % 3 ile 8’ini etkilemektedir ve hala maternal morbidite ve mortalitenin en sık nedenidir. Preklampside bozulmuş uteroplasental üniteye bağlı olarak, bu olgularda fetal ve neonatal kötü sonuçlar görülebilmektedir. Fetal ve neonatal kötü sonuçların yanında, annede de hematolojik, kardiyovasküler, pulmoner, nörolojik, renal ve gastrointestinal sistemde anlamlı ölçüde kötü sonuçlar görülebilmektedir. Bu derlemede preeklampsiye bağlı oluşan kötü maternal sonuçların değerlendirilmesi amaçlanmıştır

Comparison of serum maternal adiponectin concentrations in women with isolated intrauterine growth retardation and intrauterine growth retardation concomitant with pre-eclampsia

Objective: the aim of this study was to compare serum maternal adiponectin concentrations in pregnant women with isolated intrauterine growth retardation (IUGR) and in pregnant women with IUGR concomitant with pre-eclampsia (IUGRcwPE). Material and Methods: Thirty patients with isolated IUGR (group 1), 20 patients with IUGRcwPE (group 2), and 30 healthy controls (group 3) between age 18-40 were included into the study. Venous blood samples of those patients were obtained in the starving state. Adiponectin con- centrations were measured by enzyme-linked immunosorbent assay in serum obtained after centrifugation. To find the differences between the groups, student t-test and one-way ANOVA statistical methods were used. Results: There were no differences between the groups in terms of age, body mass index, gestational age, and parity (p>0.05). the values of amniotic fluid index (p<0.001) and weight gained during pregnancy (p=0.017) were significantly different when compared among the three groups. the mean concentrations of adiponectin were 94.041 pg/mL in the IUGR group, 55.717 pg/mL in the IUGRcwPE group, and 51.831 pg/mL in the control group. Both of the differences between the IUGR and IUGRcwPE groups (p value; <0.05) and IUGR and control groups were statis- tically significant (p value; <0.001). However, there were no significant differences between the IUGRcwPE group and control group (p>0.05). Conclusion: We found that IUGR increased maternal serum adiponectin concentrations; however, this rise does not occur in pregnant women with IUGRcwPE

Complete hydatidiform mole presenting as placenta previa in a twin pregnancy with a coexisting normal foetus: Case report

We present a case of a patient with a complete hydatidiform mole co-existing with a normal foetus (CMCF) who had a caesarean section in week 32 of gestation, resulting in a live female infant weighing 1590 grams. The mother, with a normal bleeding pattern, did not require any surgical intervention. She was discharged from hospital on the third post-operative day. Premature termination is recommended in this type of pregnancy because of the risks associated with molar pregnancies. However, with the close follow-up of these pregnancies, good maternal and perinatal results may be obtained. (We present a case of a patient with a complete hydatidiform mole co-existing with a normal foetus (CMCF) who had a caesarean section in week 32 of gestation, resulting in a live female infant weighing 1590 grams. The mother, with a normal bleeding pattern, did not require any surgical intervention. She was discharged from hospital on the third post-operative day. Premature termination is recommended in this type of pregnancy because of the risks associated with molar pregnancies. However, with the close follow-up of these pregnancies, good maternal and perinatal results may be obtained.