ABSTRACT
Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.
Subject(s)
Abortion, Spontaneous , Uterine Neoplasms , Humans , Female , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/surgery , Uterine Neoplasms/pathology , Pregnancy , Adult , Ultrasonography , Pregnancy Complications, Neoplastic/diagnostic imaging , Pregnancy Complications, Neoplastic/pathology , Pregnancy Complications, Neoplastic/surgery , Leiomyoma/diagnostic imaging , Leiomyoma/surgery , Leiomyoma/pathologyABSTRACT
Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.
ABSTRACT
OBJECTIVES: To evaluate the results of the uterine artery embolization (UAE) for the treatment of uterine fibroids. METHODS: Twenty-six patients with ultrasonographic diagnosis of uterine leiomyomata were submitted to UAE with polyvinyl alcohol particles. Imaging and clinical follow-up was performed before the procedure, at 3 months, and 1 year after. RESULTS: All procedures but one were technically successful. Control of menorrhagia and pelvic pain were reported after UAE by 87.5% and 84.2% of patients, respectively. The initial medium uterine volume was 385 cm(3), after 3 months 255 cm(3) and after 1 year 202 cm(3). The mean uterine volume decrease was 29% after 3 months and 41% after 1 year of follow-up (P<0.001). Clinical and biochemical findings consistent with ovarian failure were observed in three patients (12% of the patients). CONCLUSIONS: UAE represents a new therapeutic approach in the treatment of uterine leiomyomata. The procedure appears effective in controlling symptoms and represents an alternative to hysterectomy.
