ABSTRACT
This article provides an overview of ultrasonographic evaluation of the normal female pelvis. Pertinent pelvic anatomy is reviewed, and there is an in-depth discussion of the normal appearance of the uterus and ovaries. In addition, the indications and technique for performing 3-dimensional imaging and saline-infused sonohysterography are covered.
Subject(s)
Ovary/anatomy & histology , Pelvis/diagnostic imaging , Ultrasonography/methods , Uterus/anatomy & histology , Female , Humans , Imaging, Three-Dimensional , Ovary/diagnostic imaging , Pelvis/anatomy & histology , Sodium Chloride , Uterus/diagnostic imagingABSTRACT
BACKGROUND: Uterine arteriovenous malformations are rare and have been reported to occur after uterine trauma (eg, surgery, gestational trophoblastic disease, malignancy). CASE: A 33-year-old woman, gravida 3 para 3, presented 4 weeks post-cesarean delivery with episodic profuse vaginal bleeding. Pelvic ultrasonography and magnetic resonance imaging revealed a left uterine arteriovenous malformation. After consideration of all treatment options, total laparoscopic hysterectomy was performed. CONCLUSION: Acquired uterine arteriovenous malformations and placental ingrowth into the myometrium are increasingly reported after surgical uterine procedures. This case of a postpartum patient with both uterine arteriovenous malformation and retained placenta increta suggests a correlation between the two complications.
Subject(s)
Arteriovenous Malformations/etiology , Arteriovenous Malformations/surgery , Cesarean Section/adverse effects , Placenta Accreta/etiology , Postoperative Hemorrhage/etiology , Uterine Hemorrhage/etiology , Adult , Arteriovenous Malformations/diagnosis , Cesarean Section/methods , Female , Follow-Up Studies , Humans , Hysterectomy/methods , Immunohistochemistry , Magnetic Resonance Angiography/methods , Monitoring, Intraoperative/methods , Placenta Accreta/diagnostic imaging , Placenta Accreta/surgery , Postoperative Hemorrhage/surgery , Pregnancy , Rare Diseases , Severity of Illness Index , Treatment Outcome , Ultrasonography, Doppler/methods , Uterine Hemorrhage/surgerySubject(s)
Endometrium/pathology , Hysteroscopy , Ossification, Heterotopic/pathology , Adult , Female , Humans , Incidental Findings , MetaplasiaABSTRACT
OBJECTIVE: Oxytocin, the most commonly used uterotonic agent in the United States to prevent postpartum hemorrhage, has no established standard dose. The aim of this review is to present data on oxytocin dosing for the prevention of postpartum hemorrhage. STUDY DESIGN: We conducted a PubMed search for clinical trials that utilized oxytocin for hemorrhage prophylaxis following either vaginal or cesarean delivery. We further narrowed the results to studies that compared alternative dosing and duration of oxytocin administration. RESULTS: Seven of 46 eligible reports were selected for detailed review. We compared the dose and duration of oxytocin used, study population, and outcomes (estimated blood loss, need for additional uterotonics, and change in hematocrit after delivery). Dose of oxytocin used ranged from 5 to 100 IU and duration of administration ranged from 5 to 30 seconds (intravenous bolus) to 8 hours diluted in crystalloid. CONCLUSION: Overall, higher infusion doses (up to 80 IU/500 mL) and bolus doses of oxytocin appear to be more effective than lower doses or protracted administration of a fixed dose at reducing outcome measures of postpartum hemorrhage, particularly among cesarean deliveries.
