11 research outputs found

    An examination by year of cases applied with caesarean hysterectomy because of placenta percreta in a tertiary centre: a retrospective cohort study

    Get PDF
    Objectives: To examine cases applied with caesarean hysterectomy because of placenta percreta by comparing changesin treatment strategies and complications according to year.Material and methods: A retrospective examination was made of 93 patients applied with caesarean hysterectomy witha diagnosis of placenta percreta in 5-year periods of 2005–2009, 2010–2014, and 2015–2019. Demographic characteristicswere recorded, and previous caesareans, history of myomectomy and curettage, gestational weeks, and infant birthweight.Intraoperative and postoperative findings were recorded as operating time, length of stay in hospital and Intensive Care Unit(ICU), transfusion requirement, the amount of erythrocyte suspension (ES) and fresh frozen plasma (FFP) transfused, and requirementfor massive transfusion. Anaesthesia type, complications, and the preferred skin-uterus incision were also recorded.Results: The 93 patients comprised 8 cases in the period 2005–2009, 23 in 2010–2014, and 62 in 2015–2019. The numberof previous caesarean procedures was observed to increase in parallel with these case numbers. A significant increase wasobserved in the gestational week of birth, and infant birthweight, and a decrease in operating times. In later years there wasseen to be a lower amount of ES and FFP transfused and fewer patients with massive transfusion. Preoperative diagnosisof placenta percreta, the highest preference for general anaesthesia, selection of midline vertical skin incision and uterinefundal incision were greatest in the period 2015–2019.Conclusions: In cases with placenta percreta, of which there is an increasing incidence, maternal and infant outcomescan be optimised with prenatal diagnosis and planned caesarean hysterectomy by a multidisciplinary team with optimalprenatal preparation

    Uterine Cervix Metastasis of Myxopapillary Ependymoma Originated from the Spinal Cord

    No full text
    Background: Myxopapillary ependymomas are well differentiated low-grade tumors which have been documented to local or distant metastasis. In the literature, this is a unique case of myxopapillary ependymoma with metastasis to the uterine cervix. Here, we present a rare case of extra neural metastasis of spinal ependymoma that developed over a long period. Case Report: A 34-year-old woman was referred to our hospital for pelvic mass. A mass (110x100 mm) localized between the sacrococcygeal region and the uterus was detected by magnetic resonance imaging. In 2004, she had been operated upon for myxopapillary ependymoma seated in the sacrococcygeal region for the first time. She underwent tumor resection eight times due to the recurrence of spinal tumor in the same region in nine years. Under the diagnosis of uterine neoplasm, we carried out radical hysterectomy, omentectomy and pelvic lymphadenectomy as the surgical procedure. The pathological findings were reported as myxopapillary ependymoma. Immunohistochemically, the myxopapillary ependymal cells showed strong positivity for glial fibrillary acidic protein, whereas they were negative for low molecular weight cytokeratin. The Ki-67 labeling index was about 2-3%. The patient had an uneventful postoperative period. She has remained free of symptoms in the year since surgery. Conclusion: Extra-spinal myxopapillary ependymoma is very rare, but it must be considered in the differential diagnosis of pelvic mass lesions

    Dinoproston vajinal ovül ile doğum indüksiyonu; erken membran rüptürlü term gebelikte güvenli ve etkili midir?

    No full text
    Objective: Our aim in this study is to compare the efficacy and safety of controlledrelease dinoprostone vaginal insert in patients with intact membranes and premature rupture of membranes (PROM). Material and Methods: Eighty-six term pregnants with singleton pregnancy, with no prior uterine scar, vertex presentation, bishop score = 5, were included in the study. Patients were divided into two groups as PROM patients (n:27) and patients with intact membranes (n:59). Labor induction with controlled-release dinoprostone vaginal insert was performed to all cases. The groups were compared with each other in terms of cervical ripening, success of the induction, adverse neonatal outcomes and presence of maternal side effects. Results: In the PROM group and the intact membrane group, the cervical ripening was completed at 4th hours and at 6th hours, respectively (p=0.01 and p=0.001). The mean time to onset of active labor was 6,63 hours in the PROM group and 7,81 hours in the intact membranes group (p=0.1). There was no significant difference in low 1. and 5. minute Apgar scores, low umbilical artery pH, administration to neonatal intensive care unit, and operative vaginal delivery between the two groups. Maternal vomiting, diarrhea, uterine tachysystole were not observed and there was no case of maternal or neonatal death. Conclusion: These data overall suggest that controlled-release dinoprostone insert use is effective and safe in patients with PROM just like in patients with intact membranes.Bu çalışmada amacımız, Erken Membran Rüptürü (EMR) ve intakt membranlı hasta-- larda kontrollü salınımlı dinoproston vajinal ovülün güvenilirliğini ve etkinliğini karşılaştırmaktır. Gereç ve Yöntemler: Bishop skoru g5, baş geliş, önceden uterin skarı olmayan 86 term tekil gebe çalışmaya alındı. Hastalar EMR (n:27) ve intakt membranlı olarak (n59) iki gruba ayrıldı. Tüm va-- kalara kontrollü salınımlı dinoproston ile doğum indüksiyonu uygulandı. Gruplar servikal olgunla-- şma, indüksiyon başarısı, olumsuz yenidoğan sonuçları ve anneye ait yan etkiler açısından karşılaştırıldı. Bulgular: EMR ve membranları sağlam grupta, servikal olgunlaşma sırasıyla ve 6. saatlerde tamamlandı (p=0,01 and p=0,001). Aktif doğum fazının ortalama başlama süresi EMR gru-- bunda 6,63 saat ve membranları sağlam grupta 7,81 saaatidi (p=0,1). Düşük 1. ve 5. dakika Apgar skoru, düşük umblikal arter pH, yenidoğan yoğun bakım ünitesine başvuru ve operatif vajinal do-- ğumda iki grup arasında istatistiksel fark yoktu. Annede kusma, diyare, uterin taşisistol gözlenmedi ve maternal neonatal ölüm olmadı. Sonuç: Bu veriler kontrollü sahmli dinoproston ovül kullanımının intakt membranlı hastalarda olduğu gibi EMR hastalarda da etkili ve güvenli olduğunu göstermektedir
    corecore