Spontaneous uterine rupture at 16-week gestation after abdominal myomectomy

Uterine rupture during pregnancy after abdominal myomectomy is an uncommon complication. Most of these cases occur during the third trimester of pregnancy or during labor. We report a 16-week pregnant lady with previous history of abdominal myomectomy presenting with acute abdomen. Emergency laparotomy revealed a spontaneous uterine rupture. The fetus within the amniotic sac and the placenta were expelled in the abdominal cavity. Although it is rare, uterine rupture may occur early in pregnancy

Sub mucous fibroids [Effective surgical approach]

One case of removal of 34 submucous fibroids is presented because of its rarity

Isolated necrotising arteritis of the cervix and myometrium: a much neglected but puzzling entity.

Arteritis of the uterine cervix and corpus described here was an incidental finding at the routine histopathological examination of the hysterectomy specimen resected from a 62 year old female who underwent laparotomy for twisted ovarian cyst. Investigations and eleven months of follow up without any specific treatment for arteritis, have shown no systemic involvement. This case highlights that a knowledge of such isolated arteritis is of importance to the physician to avoid misdiagnosing it as polyarteritis nodosa and treat with systemic steroids.

Abdominal myomectomy versus abdominal hysterectomy for symptomatic and big uterine fibroids

To compare abdominal myomectomy with abdominal hysterectomy in women with big and symptomatic uterine fibroids. The hospital records at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia were reviewed to identify women who underwent abdominal myomectomy or abdominal hysterectomy between 1989 and 1999. Inclusion criteria were the presence of symptoms and size of the uterus equaling that of 12 weeks gestation or more. Women who underwent myomectomy as a treatment of infertility were excluded. During the study period, 111 women met the inclusion criteria. Thirty-eight women underwent abdominal myomectomy and 73 women underwent abdominal hysterectomy. Forty women were excluded because of myomectomy for infertility. Abdominal myomectomy was successfully performed in all women for whom it was scheduled. Hysterectomy, internal iliac ligation, or other procedures were not necessary to control the bleeding. The primary indication for myomectomy was abnormal vaginal bleeding in 23 women and pelviabdominal mass in 15 women compared to 6 women and 67 women in the hysterectomy group. There were statistically significant differences in the mean age and parity [p value 0.01 and <0.001] between women who underwent abdominal myomectomy and abdominal hysterectomy. The uterine size clinically [mean +/- standard deviation], size of largest myoma by ultrasonography, and from histopathology reports were 15.4 +/- 3.8, 11.8 +/- 2.8, and 13.6 +/- 3.2 compared to 17.9 +/- 4.4, 16.9 +/- 4.2, and 13.8 +/- 3.7 [p values not statistically significant]. Similarly, there were no statistically significant differences in the pre- and postoperative hemoglobin, estimated blood loss, rate of blood transfusion, operative time, and numbers of days in hospital. Abdominal myomectomy for big and symptomatic uterine fibroids carries similar risks to abdominal hysterectomy

Embarazo cornual: tratamiento quirúrgico laparoscópico / Cornual pregnancy: laparoscopic surgical treatment

Se presentan dos casos de embarazo cornual resueltos quirúrgicamente por laporoscopia con éxito. Se realizó salpingtomía con resección cornual y sutura endoscópica del miometrío. Ambas pacientes evolucionaron satisfactoriamente y son dadas de alta al 2ª dia postoperatorio

Management of uterine leiomyomas

A total of 116 patients of uterine leiomyomas were managed in Gynaecology and Obstetric Department of Jinnah Postgraduate Medical Centre Karachi within two years from June 1989 to May 1991. This retrospective study was carried out to evaluate the presentation of patients with fibroid uterus and to assess the complications of Surgery. All the patients were operated, of which 26 [22.4%] had myomectomy, 77 [66%] had abdominal hysterectomy, four [3.4%] had vaginal hysterectomy, while in 9 [7.8%] patients vaginal myomectomy was done. During myomectomy the only operative complication was haemorrhage that occurred in 4 [15.4%] patients. There was no mortality in this series. There was no long term follow up. Two patients [8%] conceived within six months following myomectomy

Embarazo cornual: diagnóstico precoz y tratamiento / Cornual pregnancy: early diagnosis and treatment

Se presenta un caso clínico de embarazo cornual diagnosticado y tratado precozmente, se discute su cuadro clínico y tratamiento