Ovarian Ectopic Pregnancy after Endometriomal Cyst Resection, Following In vitro Fertilization (IVF): A Rare Case Report

Background: primary ectopic pregnancy (EP), with 0.001-0.013% incidence rate, is a very scarce obstetrical condition. Among EPs Ovarian EP is more rarely seen?&nbsp;Case: We present a case of ovarian EP following In vitro fertilization in a patient with history of endometriosis and curettage. With a primary diagnosis of tubal EP, the patient underwent laparoscopy, during which ovarian pregnancy was revealed. This was later confirmed with pathological review of the specimen.&nbsp;Conclusion: Ovarian EP constitutes 3% of all EPs. Diagnosis of this condition is extremely hard before surgery; therefore, laparoscopy is considered a reliable means of diagnosis. Moreover, women conceiving with IVF-embryo transfer have a higher risk of EP.</p

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Background: Pseudo membranous colitis is a rarely reported condition in obstetrics. The clinical presentation varies from a self-limiting diarrhea to a severe pseudo membranous colitis with toxic megacolon and subsequent death. The process of this disease is mainly associated with prior antibiotic intake.&nbsp;Case presentation: A 32 year-old, G4L4RIV woman was admitted 3 days after her delivery with severe diffuse abdominal pain and distention. The patient had intravenously cefazolin after cord clamping. The colonoscopy showed pseudo membranous colitis. She was managed conservatively and after 12 days of medical treatment the patients was discharged in a good condition.&nbsp;Conclusion: In the patients with low grade fever, abdominal distention and diarrhea after delivery, pseudo membranous colitis should be considered a possible diagnosis in order initiate the treatment as soon as possible.</p

Thyroid Dysfunction and Autoantibodies Association with Hypertensive Disorders during Pregnancy

Background. Thyroid dysfunction and autoimmunity are relatively common in reproductive age and have been associated with adverse health outcomes for both mother and child, including hypertensive disorders during pregnancy. Objective. To survey the relation between thyroid dysfunction and autoimmunity and incidence and severity of pregnancy-induced hypertensive disorders. Method. In this case control study 48 hypertensive patients in 4 subgroups (gestational hypertension, mild preeclampsia, severe preeclampsia, eclampsia) and 50 normotensive ones were studied. The samples were nulliparous and matched based on age and gestational age and none of them had previous history of hypertensive or thyroid disorders and other underlying systemic diseases or took medication that might affect thyroid function. Their venous blood samples were collected using electrochemiluminescence and ELISA method and thyroid hormones and TSH and autoantibodies were measured. Results. Hypertensive patients had significant lower T3 concentration compared with normotensive ones with mean T3 values 152.5±48.93 ng/dL, 175.36±58.07 ng/dL respectively. Anti-TPO concentration is higher in control group 6.07±9.02 IU/mL compared with 2.27±2.94 IU/mL in cases. Conclusion. The severity of preeclampsia and eclampsia was not associated with thyroid function tests. The only significant value was low T3 level among pregnancy, induced hypertensive patients

Direct Proportional Relationship between Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Endometriotic Cyst: Evaluating the Effects on Ovarian Reserve

Background: The aim of this study was to evaluate ovarian damage following laparoscopic endometrioma cystectomy using ultrasound and pathologic samples.&nbsp;Materials and Methods: This is a prospective cohort study in General Women Hospital affiliated to Tehran University of Medical Sciences. 40 patients with endometrioma, total of 44 cysts including bilateral cysts, underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound.Results: Mean antral follicle count (AFC) before the operation was 4 ± 1.29 and after operation was1.64 ± 1.03. The reduction in AFC after cystectomy was statistically significant (P &lt;0.000), and with each 1 centimeter increase in cyst diameter a reduction of AFC averaging 0.421 was observed. On pathological examination, it was shown that every millimeter of inadvertently excised ovarian tissue and cyst wall fibrosis thickness leads to reduction of 1.06 and 1.2 in AFC respectively.&nbsp;Conclusion: Laparoscopic cystectomy for endometrioma is associated with reduction in ovarian reserve and this reduces proportionally with cyst diameter, amount of normal ovarian parenchyma excised and cyst wall fibrosis.&nbsp;</p

Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Nonendometriotic Cyst: The Evaluating Effects on Ovarian Reserve

Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7 rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts (17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts) underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger teratomas and more parenchyma inadvertently removed during their excision (1.64, 0.255) reduced AFC was seen and in simple serous cysts with more removed parenchyma amount (1.5) reduced AFC occurred. In our study simple cysts excision led to a loss in AFC that was not associated with any other cyst parameters. Mucinous cysts resection led to no specific ovarian reserve damage. Laparoscopic cystectomy for non-endometriosis leads to reduced ovarian reserve