39 research outputs found
Sonographically Diagnosed Vault Hematomas Following Vaginal Hysterectomy and Its Correlation with Postoperative Morbidity
Objective. Our aim is to investigate sonographically detectable vault hematomas after vaginal hysterectomy and its relation to postoperative morbidity. Methods. We studied a group of 103 women who had undergone vaginal hysterectomy for benign causes apart from uterovaginal prolapse. Transabdominal ultrasound examinations were carried out 24 to 72 hours after surgery to assess the presence of vault hematomas. Ultrasound findings were correlated with clinical data and postoperative morbidity. Results. The incidence of vault hematoma was found 19.4% in present study. In these patients, 40% (8/20) had fever while only 2.4% (2/83) of cases without vault hematoma suffered from fever. Out of all women having vault hematoma, 70% (14/20) had small-sized hematoma and 30% (6/20) had large-sized hematoma. Fifty percent of patients (3/6) with large-sized hematoma, as compared to only 35% (5/14) with small-sized hematoma, suffered from febrile morbidity. Large-sized hematomas drained by vaginally, while all small-sized pelvic hematomas managed by watchful expectancy successfully. The significant difference was found mean hemoglobin drop and postoperative stay in the hematoma group or without hematoma group. Conclusion. Sonographic detection of vaginal vault fluid collection is common after hysterectomy, but such a finding rarely indicates additional treatment. Though febrile morbidity was more in cases with vault hematoma, the number of such patients was too small to be significant. Vaginal ultrasound examination should not be performed routinely after hysterectomy
The effects of anemia in pregnancy on the mode of delivery and newborn
Objective: The aim of this study is to evaluate the effects of anemia in pregnancy on the mode of delivery and new-born.
Methods: Between June and October 2009, 307 pregnant women were evaluated in terms of hemoglobin (Hb) and hematocrit (Hct) values, and delivery mode retrospectively. And also, the first and fifth minute Apgar scores, birth weight, and the values of Hb, Hct, and bilirubin, which obtained from the cord blood of neonates, were analyzed. Pregnant women were divided into two groups and classified as: hemoglobin value under 11.1 g / dl as anemic and the others as non-anemic group. In addition, the anemic group were divided into three group in terms of hemoglobin value, as follows: Group 1: 10.1 -11 mg/dl, group 2: 9.1 - 10 mg/dl, and group 3: <9 mg/dl.
Results: In the study, 146 pregnants were anemic, while the 161 were non-anemic. The rate of low birth weight neonates was significantly higher in anemic pregnant women (p=0.029). The values of Hb (p=0.026) and Htc (p=0.006) were found to be lower in the anemic pregnantâ neonates. The incidence of low birth weight was significant increased when the maternal Hb value was smaller than 10g/dl (62.5% sensitivity, 74.7% specificity).
Conclusion: It is observed that the low birth weight and the low values of Hb and Hct were more common in anemic pregnant neonates. Therefore, anemia should be screened and treated during the pregnancy due to the potential negative consequences
Vitamin D status in the first-trimester: effects of Vitamin D deficiency on pregnancy outcomes
Objective: To assess serum levels of 25-hydroxyvitamin D [25(OH)D] in the first trimester and to determine the factors affecting deficiency levels and its association with pregnancy outcomes.Methods: Serum 25(OH)D concentrations were measured at 11-14 weeksâ gestation in 229 singleton pregnancies using liquid chromatography-tandem mass spectrometry.Results: The median serum 25(OH)D concentration was 10.8 ng/mL and 45.9% of women had severe vitamin D deficiency with concentrations of <10 ng/mL. Logistic regression analysis revealed that covered dressing style, lack of multivitamin intake, season of blood sampling (November-April) were factors associated with 25(OH)D deficiency. There was a negative correlation between 25(OH)D levels and gestational age at sampling. Low 25(OH)D levels were not associated with adverse pregnancy outcomes. Higher rate of cesarean section (CS) was noted in women with 25(OH)D â„10 ng/mL compared to those with 25(OH)D < 10mg/ml ( p= 0.01).Conclusion: A high prevalence of vitamin D deficiency was observed in early pregnancy which was related to dress code, use of multi-vitamins and season at sampling. Low 25(OH)D levels were not related with adverse pregnancy outcomes. Women with severe vitamin D deficiency were more likely to deliver vaginally.Keywords: 25-hydroxyvitamin D; pregnancy outcome; vitamin D deficienc
Vitamin D status in the first-trimester: effects of Vitamin D deficiency on pregnancy outcomes.
Objective: To assess serum levels of 25-hydroxyvitamin D [25(OH)D] in
the first trimester and to determine the factors affecting deficiency
levels and its association with pregnancy outcomes. Methods: Serum
25(OH)D concentrations were measured at 11-14 weeks\u2019 gestation in
229 singleton pregnancies using liquid chromatography-tandem mass
spectrometry. Results: The median serum 25(OH)D concentration was 10.8
ng/mL and 45.9% of women had severe vitamin D deficiency with
concentrations of <10 ng/mL. Logistic regression analysis revealed
that covered dressing style, lack of multivitamin intake, season of
blood sampling (November-April) were factors associated with 25(OH)D
deficiency. There was a negative correlation between 25(OH)D levels and
gestational age at sampling. Low 25(OH)D levels were not associated
with adverse pregnancy outcomes. Higher rate of cesarean section (CS)
was noted in women with 25(OH)D 6510 ng/mL compared to those with
25(OH)D < 10mg/ml ( p= 0.01). Conclusion: A high prevalence of
vitamin D deficiency was observed in early pregnancy which was related
to dress code, use of multi-vitamins and season at sampling. Low
25(OH)D levels were not related with adverse pregnancy outcomes. Women
with severe vitamin D deficiency were more likely to deliver vaginally
A Foreign Body (Gossypiboma) in Pregnancy: Report of the First Case in the Pregnancy
Gossy piboma is a rare tumor caused by gauze fibers retained during surgery. To our knowledge, a gossy piboma in the abdomen in pregnancy has not been previously reported in the literature. A 27-year-old woman at 38 weeks of gestation was presented with adnexial mass. A caesarean delivery had been performed 5 years ago. Obstetrics ultrasonography showed thick curvilinear hyperechoic band
with distal acoustic shadowing in the pubic region. In caesarean section, a well-encapsulated, brownish sof t-tissue tumor containing serous fluid was discovered in the central cavity, shown at histological investigation to be gauze fibers. The frequency incidence is not very well known; however general estimation is 1 in 1000 to 15000 f or intra-abdominal operations. The best prevention of this condition can be achieved by meticulous count of surgical materials and also by routine use of surgical textile materials impregnated with a radio-opaque marker
Semilobar holoprosencephaly with associated cyclopia and radial aplasia: first trimester diagnosis by means of integrating 2D-3D ultrasound
Holoprosencephaly (HPE) is commonly associated with facial malformations. We present a case of semilobar HPE associated with distal limb defect which was detected at 12 weeks of gestation
A Complete Gonadal Dysgenesis Case with Mental Retardation, Congenital Hip Dislocation, Severe Vertebra Rotoscoliosis, Pectus Excavatus, and Spina Bifida Occulta
Background: 46,XY, or Swyer syndrome, is a complete gonadal dysgenesis. Patients usually presents with primary amenorrhea with underdeveloped secondary sex characteristics. Phenotypes of these patients are female. In this report, a Swyer syndrome case is reported with novel clinical features that are classified as connective tissue disorders. This case and the 2 other previously reported Swyer syndrome cases with ascendant aortic aneurysm and diaphragmatic hernia are suggest that the Y chromosome has an important role in the structure of connective tissue
Jarcho-levin syndrome presenting as neural tube defect: Report of four cases and pitfalls of diagnosis
Jarcho- Levin syndrome ( JLS) causes severe vertebral and thoracic deformity and has an autosomal- recessive mode of inheritance. Prenatal diagnosis may be difficult in some cases without the history of an affected baby. We present 4 cases of JLS with neural tube defects as the prominent finding. In 2 of them the deformity of the thorax was minimal and was not detected by ultrasonography. Rib anomalies were revealed with radiological and pathological examinations after the termination. The location of the vertebral defect may be the determinant factor for the severity of the thoracic deformity. The real recurrence risk could only be found out after postnatal examinations in cases with neural tube defects