ABSTRACT
A 47-year-old Chinese lady presented at our clinic with an intermittent pelvic discomfort for years. Pelvic examination was unremarkable. Transvaginal scan revealed an anteflexed uterus containing a dense echogenic circular device, 3 centimeters in diameter. The heavy sonographic reverberation pattern suggested its metallic composition. Examination with three-dimensional sonographies (3D US) in a reconstructed coronal plane (C plane) with soft tissue subtraction showed a perfectly round intrauterine device (IUD). This device was centrally located and positioned along the axis of the upper part of the uterine cavity. No evidence of myometrial migration was found. To the best of our knowledge, this article presents the first 3D image of this rare device. It also suggested the application of 3D sonographies in determining the contraceptive efficacies and management plans. 3D US images that are related to the intrauterine device were also shown and discussed.
ABSTRACT
OBJECTIVE: To evaluate adverse pregnancy outcome in women diagnosed with gestational diabetes mellitus (GDM) at Siriraj hospital. STUDY DESIGN: Cross- sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: One hundred and sixty two women who were diagnosed with GDM and who received treatment following clinical practice guideline at Siriraj hospital were enrolled. Data were abstracted from medical record regarding adverse pregnancy outcomes of both the mothers and their infants. RESULTS: The most common clinical risk for GDM was age > or = 30 years (116 cases, 71.6%), followed by family history of diabetes mellitus (81 cases, 50%) and obesity (47 cases, 29%). Majority of the women were GDM class A1 (156 cases, 96.3%) and only six cases (3.7%) were GDM class A2. Maternal complications were found in 35 cases (21.6%) and the most common complications were postpartum hemorrhage (17 cases, 10.5%), mild preeclampsia (6 cases, 3.7%) and severe preeclampsia (3 cases, 1.9%). The most common neonatal complication was hypoglycemia (111 cases, 68.5%). This occurred in all infant of GDM class A2 mothers. Macrosomia was found in 29 cases (17.9%). No significant differences in maternal and neonatal complications were found between GDM class A1 and class A2. CONCLUSION: Women with GDM who were diagnosed and treated following treatment guidelines demonstrated no severe maternal and neonatal complications.