ABSTRACT
These are natural inhibitors of coagulation, and deficiencies of any of these factors is referred to as thrombophilia. The identified main causes of thrombophilia are deficiencies of antithrombin III, protein C, or protein S, resistance to actived protein C associated with Factor V Leiden mutation, and inherited hyperhomocystinemia. Inherited and acquired thrombophilias may also contribute to pathophysiological processes involved in recurrent pregnancy loss, fetal death, intrauterine growth restriction, placental abruption, placental infarction, and pre-eclampsia. Various therapeutic protocols with low-molecular-weight heparin (LMWH) were used. because it is associated with a low incidence of osteoporosis and thrombocytopenia. We experienced the two cases of successful deliveries by Cesarean section following a successful pregnancy maintenance in thrombophilia. we administered LMWH to prevent thromboembolism. one patient was the primi-gravidarum, with inherited thrombophilia, who has the familial history of pulmonary embolism and deep vein thrombosis. the other was the multi-gravidarum, with acquired thrombophilia, who has the past medical history of pulmonary embolism.
Subject(s)
Female , Humans , Pregnancy , Abruptio Placentae , Antithrombin III , Cesarean Section , Factor V , Fetal Death , Heparin, Low-Molecular-Weight , Incidence , Infarction , Osteoporosis , Pre-Eclampsia , Pregnancy Maintenance , Protein C , Protein S , Pulmonary Embolism , Thrombocytopenia , Thromboembolism , Thrombophilia , Venous ThrombosisABSTRACT
An intravaginal foreign body of long duration can lead to infection and ulceration. Foul-smelling, bloody vaginal discharge, and pelvic pain may indicate the presence of an intravaginal foreign body and symptoms may be referred to the bladder or rectum. But these clinical features are nonspecific and a number of diagnostic modalities may fail to detect the presence of the foreign body. Moreover, long-standing intravaginal foreign body may be difficult to distinguish from an advanced cervical cancer especially in uninformed cases. We present a case of a 41-year-old female who suffered from an aggravating chronic pelvic pain and malodorous dirty vaginal discharge. Initially the advanced cervix cancer complicated with recto-vaginal fistula was suspected. But results of repeated biopsies were benign and symptoms were improved by intravenous antibiotics. Finally the embedded foreign body in the posterior fornix was detected and successfully removed. It was proved as the grip of an umbrella. We concluded that a high index of suspicion is very important for the correct diagnosis of long-standing vaginal foreign body especially in uninformed cases.