ABSTRACT
OBJECTIVE: A review of meconium pathophysiology and its contribution to the incidence of postnatal neurological handicap. DESIGN: Reviewed article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. SUBJECT AND METHOD: Meconium can be a cause of infant neurological handicap. Two main pathogenetic pathways are mentioned. 1. Meconium (and its components: bile acids) may have a direct vasoconstrictive effect on umbilical and placental vessels. This way still remains controversial. 2. Meconium as a possible cause of intraamniotic infection results in a release of fetal cytokines (TNF alpha, IL-1 beta, IL-6), which can damage myelinogenesis in periventricular white matter. RESULTS: Meconium in premature labour is a higher risk factor compared to term delivery. 41% of premature infants were diagnosed as having CP when meconium was present compared to 10% in the same group with clear amniotic fluid. The incidence in term pregnancy with meconium present is 0.4% compared to 0.3% in a population without any obstetrical risk. CONCLUSION: Ultrasonographically found periventricular leukomalacia is the most reliable sign of subsequent cerebral palsy or other neurological sequelae.
Subject(s)
Amniotic Fluid , Brain Damage, Chronic/etiology , Cerebral Palsy/etiology , Meconium , Chorioamnionitis/etiology , Female , Humans , Infant, Newborn , Leukomalacia, Periventricular/etiology , Placenta/blood supply , PregnancyABSTRACT
We report two cases of prolapse of the fallopian tube associated with an exuberant angiomyofibroblastic stroma response, which occurred after hysterectomy and which is a hitherto unreported feature of this lesion. The tumors were composed of richly vascularized stroma arranged in a retiform pattern and mildly atypical glandular inclusions, which had the morphology of tubal epithelium. The stroma of the lesion was composed of either thin bipolar cells with tapered nuclei and stellate-shaped cells with minimal amount of cytoplasm or small epithelioid-looking cells with eosinophilic cytoplasm. The tubal glandular inclusions displayed mildly atypical nuclear features. If the tubal glandular component was overlooked, these tumors might be erroneously diagnosed as mesenchymal lesions of the vagina, such as vaginal fibroepithelial polyp, angiomyofibroblastoma, aggressive angiomyxoma, or superficial myofibroblastoma.
Subject(s)
Angiomyoma/pathology , Fallopian Tube Diseases/diagnosis , Hysterectomy/adverse effects , Adult , Fallopian Tube Diseases/pathology , Female , Humans , Middle Aged , ProlapseABSTRACT
OBJECTIVE: A review of meconium patophysiology and its contribution to the incidence of perinatal infection. DESIGN: Review article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. METHOD: The reported incidence of meconium-stained amniotic fluid varies between 7 and 22%. The patophysiology of the presence of meconium in the amniotic fluid is not sufficiently explained. Meconium in fetal bowels is under hormonal and neurol control. The presence of the meconium-stained amniotic fluid was always considered to be a potential risk for the fetal and neonatal well-being. The review is further divided in to three chapters. (II. Meconium and meconium aspiration syndrome, III. Meconium and postnatal neurological handicap). RESULTS AND CONCLUSION: The first chapter on deals with meconium risk in the development of perinatal infection: intraamniotic infection/chorioamnionitis, postnatal endometritis, infection of the abdominal wound after Caesarean and neonatal infection. The incidence of clinical chorioamnionitis is 15% with the presence of meconium compared to 3% in controls. The incidence of puerperal endometritis is 10% in comparison to 3% under normal conditions. Two main mechanisms of development (or coincidence) of intraamniotic infection in the presence of meconium exist. 1) Infection may be a cause of meconium passage. 2A) Alteration of Zn/P ratio in the amniotic fluid can promote bacterial growth. 2B) Meconium attached to macrophages or absorbed by phagocytosis can impair cellular immune response. The antibiotic prophylaxis is discussed.
Subject(s)
Meconium , Amniotic Fluid/chemistry , Cesarean Section , Chorioamnionitis/etiology , Endometritis/etiology , Female , Humans , Infant, Newborn , Infections/etiology , Meconium/physiology , Pregnancy , Puerperal Infection/etiology , Risk Factors , Surgical Wound Infection/etiologyABSTRACT
OBJECTIVE: A rare case of a mixed cervical carcinoma is described. SUBJECT: Glassy-cell carcinoma of the uterine cervix in association with a bilateral benign superficial serous papilloma of the ovary in a 44-year-old woman. CONCLUSION: The possible occurrence of aggressive tumours of the uterine cervix with emphasis on their adequate treatment is pointed out. At the same time the importance of a peroperative biopsy of suspect macroscopic findings on the ovaries is stressed. The paper reports on a previously unpublished case of simultaneous occurrence of the above mentioned tumours.
