RESUMO
Pheochromocytoma during pregnancy is very rare tumor, and this condition is life threatening to both mother and fetus. We describe a case of pheochromocytoma antenatally diagnosed at the midtrimester in gestation. A patient was transferred to National Medical Center during gestational week 24 with severe hypertension, generalized edema. Pheochromocytoma caused by a left adrenal mass was diagnosed. The patient was treated with titrated dose of phenoxybenzamine, propranolol, and intravenous nicardipine, but, intermittent severe hypertension was developed. At 33 weeks gestation, fetal distress was developed, and emergent c-sec was done. Two weeks after delivery, she underwent a successful left adrenalectomy. Two months after surgery, all antihypertensive medications were discontinued and her blood pressure have remained normal range.
Assuntos
Feminino , Humanos , Gravidez , Adrenalectomia , Pressão Sanguínea , Edema , Sofrimento Fetal , Feto , Hipertensão , Mães , Nicardipino , Fenoxibenzamina , Feocromocitoma , Segundo Trimestre da Gravidez , Propranolol , Valores de ReferênciaRESUMO
Of all forms of ectopic gestation, the possibility of fertility catastrophe is highest with a cervical pregnancy. Though rare, it is a potentially life-threatening condition. In the past it was diagnosed late, after there was profuse hemorrhage from the cervix and it usually required hysterectomy. With ultrasound, diagnosis can be made earlier and conservative management attempted in order to preserve the reproductive potential. Methotrexate has been used both systemically and intra-amniotically to treat cervical ectopic gestation conservatively.
Assuntos
Feminino , Gravidez , Colo do Útero , Diagnóstico , Fertilidade , Hemorragia , Histerectomia , Metotrexato , UltrassonografiaRESUMO
Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Assuntos
Adulto , Feminino , Humanos , Lactente , Gravidez , Medula Óssea , Cesárea , Hematopoese , Incidência , Síndromes Mielodisplásicas , Ruptura , Ruptura UterinaRESUMO
Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Assuntos
Adulto , Feminino , Humanos , Lactente , Gravidez , Medula Óssea , Cesárea , Hematopoese , Incidência , Síndromes Mielodisplásicas , Ruptura , Ruptura UterinaRESUMO
Primary ovarian pregnacy is a rare form of ectopic pregnacy of which an estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian may reveal a higher incidence than reported earlier. Ovarian pregnancy is uaually accompanied with the rupture of the ovary and massive hemoperitoneum. It usually presents with abdominal pain, menstural irregularities, vaginal bleeding, a palpable adnexal mass and other symptoms which are very similar to those of tubal ectopic pregnacy and hemorrhgic corpus luteum cysts. Risk factors to ovarian pregnancy include a history of pelvic inflammatory disease (PID), prior pelvic surgery, and use of an intrauterine contraceptive devices (IUD). We have experienced three cases of ovarian pregnancy, which are presented with a brief review of the literature.
Assuntos
Feminino , Gravidez , Dor Abdominal , Diagnóstico , Hemoperitônio , Incidência , Dispositivos Intrauterinos , Cistos Ovarianos , Ovário , Doença Inflamatória Pélvica , Gravidez Ectópica , Fatores de Risco , Ruptura , Hemorragia UterinaRESUMO
Primary ovarian pregnacy is a rare form of ectopic pregnacy of which an estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian may reveal a higher incidence than reported earlier. Ovarian pregnancy is uaually accompanied with the rupture of the ovary and massive hemoperitoneum. It usually presents with abdominal pain, menstural irregularities, vaginal bleeding, a palpable adnexal mass and other symptoms which are very similar to those of tubal ectopic pregnacy and hemorrhgic corpus luteum cysts. Risk factors to ovarian pregnancy include a history of pelvic inflammatory disease (PID), prior pelvic surgery, and use of an intrauterine contraceptive devices (IUD). We have experienced three cases of ovarian pregnancy, which are presented with a brief review of the literature.
Assuntos
Feminino , Gravidez , Dor Abdominal , Diagnóstico , Hemoperitônio , Incidência , Dispositivos Intrauterinos , Cistos Ovarianos , Ovário , Doença Inflamatória Pélvica , Gravidez Ectópica , Fatores de Risco , Ruptura , Hemorragia UterinaRESUMO
Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancy, but it has been increased. Ectopic pregnancy is associated with significant mortality if not promptly diagnosed. Careful pelvic examination combined serial beta-hCG determinations and transvaginal sonography to evaluation the adnexal region are necessary prerequisites for early diagnosis. We report a case of discovery of heterotopic pregnancy after elective abortion with brief review of literature.
Assuntos
Feminino , Gravidez , Diagnóstico Precoce , Exame Ginecológico , Incidência , Mortalidade , Gravidez Ectópica , Gravidez HeterotópicaRESUMO
OBJECT: The nonstress test(NST) and complete biophysical profile(BPP) were compared with the rapid biophysical profile(BPP) in order to evaluate the efficacy of the rapid BPP, namely, the combination of amniotic fluid index(AFI) and sound-provoked fetal movement(SPFM) detected by ultrasound, in predicting intrapartum fetal distress in high-risk pregnancies. STUDY DESIGN: From JAN 9th 2000, through JAN 5th 2001, the prospective study of diagnostic tests was conducted on a total of 91 high-risk singleton pregnancies, undergoing antepartum assessment both the standard NST and the new rapid BPP(including other indices of complete BPP). The diagnostic indices of the NST, rapid BPP and complete BPP were calculated in term of predicting intrapartum fetal distress. RESULT: The sensitivity, specificity, negative predictive value, and positive predictive value of NST were 50.00, 94.81, 96.05, and 42.86% respectively, and those of rapid BPP were 75.00, 98.53, 98.53, and 75.00%, and those of complete BPP were 83.33, 98.72, 98.72, and 83.33%, as well. In addition, the efficiency of NST, rapid BPP, and complete BPP were 91.57%, 97.22% and 97.62% respectively. CONCLUSIONS: The rapid BPP is an effective and reliable predictor of intrapartum fetal distress with high-risk pregnancies. Moreover, it may be inexpensive and less time-consuming method.
Assuntos
Feminino , Gravidez , Líquido Amniótico , Testes Diagnósticos de Rotina , Sofrimento Fetal , Gravidez de Alto Risco , Estudos Prospectivos , Sensibilidade e Especificidade , UltrassonografiaRESUMO
OBJECTIVE: This study investigated changes of voice and hearing in premenopausal and postmenopausal woman METHODS: We studied forty postmenopausal and forty premenopausal women. Each women was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The phonated sound in each case was recorded and analysed by the computerized speech lab (LSL 4300B, KAY Elemetrics Corp. USA). we also conducted audiometric pure-tone threshold testing on the same group. Statistical analysis of voice and hearing parameters was done by paired T test RESULTS: Jitter in menopausal group was significantly increased compared with premenopausal group, but other voice parameters showed no significant differences. There were no significant changes of vocal parameters between menopausal patients with or without vocal symptoms. And there were no significant changes of hearing parameters, either CONCLUSION: The change of voice parameters was objectively identified in menopausal women, and so therapist of menopausal symptoms must take the voice changes into consideration.
Assuntos
Feminino , Humanos , Audição , Menopausa , VozRESUMO
OBJECTIVES: We intended to evaluate the relationship between voice and the menopause, so we observed vocal symptoms and voice parameters in patients of postmenopausal syndrome compared with those in premenopausal women. MATERIALS AND METHODS: Forty postmenopausal and twenty premenopausal women were included in this study. Each woman was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The voices were recorded and analyzed by the Multi-Dimensional Voice Program and a Laryngograph. A statistical analysis of voice parameters was done by a paired-t-test. RESULTS: Vocal symptoms detected in the menopausal women were lowered pitch, voice fatigue, recurrent hoarseness, and loss of high tone. Jitter in postmenopausal group was significantly increased compared with the premenopausal group, but the fundamental frequency, shimmer, the Harmonics-to-noise ratio and the closing quotient showed no significant differences. There were no significant changes of voice parameters between menopausal patients with and without vocal symptoms. CONCLUSION: The change of voice may be objectively identified in postmenopausal women. In treating the postmenopausal symptoms, it may be required to take voice changes into consideration.
Assuntos
Feminino , Humanos , Rouquidão , Menopausa , Distúrbios da Voz , VozRESUMO
No abstract available.
RESUMO
No abstract available.