Cantrell’s pentalogy: A case report

Cantrell’s pentalogy is a rare congenital malformation which consists of the supraumbilical abdominal wall defect, the defect in the lower sternum, the agenesis of the anterior portion of the diaphragm, the absence of the diaphragmatic part of the pericardium, and the structural cardiac anomaly. This congenital malformation has a high mortality rate of in the postnatal period. Its etiopathogenesis is not yet certain. It is thought to be due to the lack or inadequacy of the migration of lateral mesoderm in the early weeks of pregnancy. Five main phenotypic findings of Cantrell’s pentalogy may not always be present in the affected cases because of the alterations in the migration defects. The subjects diagnosed with Cantrell’s pentalogy can be examined in three categories based on the phenotypic features. This is a case report of a 13-week-old pregnancy which is diagnosed with Cantrell’s pentalogy due to the presence of cystic hygroma, ectopia cordis, omphalocele and atrioventricular septal defect.Cantrell pentalojisi; supraumbilikal torako-abdominal duvar defekti, diyafram ön kısmının olmaması, perikardın diyaframla ilişkili parçasının olmaması, sternum alt bölgesinde defekt ve kalp anomalileri ile tanımlanan, nadir görülen ve postnatal dönemde mortalite oranı yüksek seyreden bir doğumsal malformasyondur. Etyopatogenezi tam olarak bilinmese de gebeliğin erken haftalarında lateral mezodermin migrasyonundaki yetersizliğe ya da eksikliğe bağlı olduğu düşünülmektedir. Migrasyon yetersizliğindeki defekte ve oluştuğu gestasyonel haftadaki değişikliğe bağlı olarak, yukarıda sayılan beş ana fenotipik bulgu her zaman görülmeyebilir. Cantrell pentalojisi, kendi arasında görülen fenotipik özelliklere göre üç sınıfa ayrılır. Bu olgu sunumunda kistik higroma, ektopia kordis, atrioventriküler septal defekt ve omfalosel nedeniyle sevk edilen ve Cantrell pentalojisi tanısı konulan 13 haftalık bir gebelik tarif edilmiştir

Maternal and umbilical cord ischemia-modified albumin levels in nonreassuring fetal heart rate tracings regarding the mode of delivery

Objective: To evaluate umbilical cord blood ischemia-modified albumin (IMA) levels in cases of fetal distress (FD) and to explore fetal blood IMA levels regarding the route of delivery. Methods: Umbilical cord and maternal serum IMA concentrations were assessed in term 40 cases with cesarean section (CS) due to FD, 76 cases with elective repeat CS and 85 cases with noncomplicated vaginal delivery. Results: The maternal and umbilical cord IMA levels were significantly lower in vaginal deliveries when compared with CS cases either in FD or previous CS groups (p = 0.02). Although no statistically significant difference was found in IMA levels of CS groups (previous CS vs. FD), cord blood IMA levels tend to be higher in FD group. Neither demographic characteristics nor fetal outcome parameters were found to have any correlation with maternal IMA levels. However, umbilical cord IMA levels were found to be negatively correlated with 1th min Apgar scores (r = –0.143, p = 0.043). Conclusions: IMA seems to be responsive to hypoxic FD showing the highest levels in cases with severe fetal hypoxia. Higher levels of IMA in cases with elective repeat CS might indicate acute transient hypoxia and possible myocardial ischemia in these cases

Tubal Polyp Causing Postmenopausal Bleeding: Case Report

This is the first case of tubal polyp detected at the age of menapouase causing postmenapousal bleeding. The only finding was thickened endometrium at transvaginal ultrasonography. After hysteroscopic polypectomy, the endometrial thickness were within normal range for menapouse and at the follow-up the bleeding did not recur. Hysteroscopic polypectomy lead to subjective improvement in symptoms of bleeding and high satisfaction rates in this case. In postmenopausal persistent vaginal bleeding and increased endometrial thickness, intramural tubal polyps might be kept in mind in differential diagnosis. In such a situation hysteroscopy seems to be a simple method both for diagnosis and treatment instead of repetetive endometrial biopsies

Postmenopozal kanamaya neden olan tubal polip: Olgu sunumu

Bu olgu postmenopozal kanamaya neden olan ve menopoz döneminde saptanan ilk tubal polip olgusudur. Hastadaki tek bulgu transvajinal ultrasonografide saptanan artmış endometriyal kalınlıktı. Histeroskopik polipektomi sonrasında endometriyal kalınlık normal sınırlara döndüğü ve takiplerde vajinal kanama tekrarlamadığı görüldü. Bu olguda histeroskopik polipektomi kanama bulgusunu tamamen ortadan kaldırarak yüksek başarı sağlamıştır. Postmenopozal kadınlarda sebat eden vajinal kanama ve artmış endometrial kalınlık varlığında, intramural tubal polipler ayırıcı tanıda göz önünde bulundurulmalıdır. Böyle durumlarda tekrarlayan endometriyal örneklemeler yerine histeroskopik inceleme yapmak hem tanı hem de tedavi açısından daha faydalı olacaktır.This is the first case of tubal polyp detected at the age of menapouase causing postmenapousal bleeding. The only finding was thickened endometrium at transvaginal ultrasonography. After hysteroscopic polypectomy, the endometrial thickness were within normal range for menapouse and at the follow-up the bleeding did not recur. Hysteroscopic polypectomy lead to subjective improvement in symptoms of bleeding and high satisfaction rates in this case. In postmenopausal persistent vaginal bleeding and increased endometrial thickness, intramural tubal polyps might be kept in mind in differential diagnosis. In such a situation hysteroscopy seems to be a simple method both for diagnosis and treatment instead of repetetive endometrial biopsies