RESUMEN
OBJECTIVE: Pelvic abscess during pregnancy is an uncommon complication, but can lead to adverse perinatal outcomes during pregnancy. CASE REPORT: We present a patient who developed rupture of a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer. Thirty-eight reported cases are reviewed, and transvaginal oocyte retrieval, genital tract infections, endometrioma, and previous pelvic surgery are considered as risk factors for pelvic abscess during pregnancy. CONCLUSION: Prolonging gestational duration when an infection situation is allowed is the principle of treatment.
Asunto(s)
Absceso/terapia , Antibacterianos/administración & dosificación , Drenaje/métodos , Enfermedades de las Trompas Uterinas/terapia , Enfermedades del Ovario/terapia , Complicaciones Infecciosas del Embarazo , Ultrasonografía Prenatal/métodos , Absceso/diagnóstico , Absceso/etiología , Adulto , Diagnóstico Diferencial , Enfermedades de las Trompas Uterinas/diagnóstico , Enfermedades de las Trompas Uterinas/etiología , Femenino , Fertilización In Vitro/efectos adversos , Estudios de Seguimiento , Humanos , Recién Nacido , Inyecciones Intravenosas , Enfermedades del Ovario/diagnóstico , Enfermedades del Ovario/etiología , Embarazo , Resultado del Embarazo , Rotura EspontáneaRESUMEN
AIMS: Aerobic vaginitis (AV) is a newly defined clinical entity which may interfere with women's reproductive health and have negative effects on pregnancy. This study was to identify the risk factors for AV. METHODS: Participants in this case-control study included healthy women and women with AV. All participants completed a standardized questionnaire covering sociodemographic factors, sexual behaviors, personal hygiene habits and health behaviors. Uni- and multivariate logistic regression analyses were used for statistical evaluation. RESULTS: A total of 290 women of reproductive age were enrolled. In the multivariate analysis, unmarried status (odds ratio [OR] 2.606, 95% confidence interval [CI] 1.257-5.402), use of an intrauterine device (OR 4.989, 95% CI 1.922-12.952), long-term use of antibiotics (OR 11.176, 95% CI 1.363-91.666) and frequent vaginal douching (OR 4.689, 95% CI 1.363-16.135) were independent risk factors for AV. On the contrary, consistent condom use (OR 0.546, 95% CI 0.301-0.991) and college-level education or above (OR 0.255, 95% CI 0.131-0.497) were independent protective factors. CONCLUSION: Measures that may be considered to prevent AV include enhancing education to improve women's knowledge related to reproductive health, especially unmarried women, encouraging them to consistently use condoms as a contraceptive method, to avoid long-term use of antibiotics and to stop frequent vaginal douching. © 2015 S. Karger AG, Basel.
RESUMEN
Van Wyk and Grumbach syndrome is characterized by a long-standing history of hypothyroidism, high levels of thyroid-stimulating hormone, uni- or bilateral ovarian cysts, isosexual precocity and a delayed bone age. All of the features can be reversed with treatment of the underlying hypothyroidism. Here, we describe two cases of Van Wyk and Grumbach syndrome presenting with bilateral multicystic ovaries and enlargement of the pituitary gland. One patient suffered from ovarian cyst and hypophysoma resection, the other patient promptly responded to L-thyroxine with complete regression of the ovarian cyst and other symptoms.
Asunto(s)
Hipotiroidismo/diagnóstico , Quistes Ováricos/diagnóstico , Neoplasias Hipofisarias/diagnóstico , Prolactinoma/diagnóstico , Tirotropina/sangre , Niño , Femenino , Humanos , Hipotiroidismo/tratamiento farmacológico , Neoplasias Hipofisarias/cirugía , Prolactinoma/cirugía , Pubertad Precoz/diagnóstico , Síndrome , Tiroxina/uso terapéutico , Adulto JovenRESUMEN
PURPOSE: To investigate the clinical features of aerobic vaginitis (AV) and mixed infections with AV to achieve efficient diagnosis. METHODS: From April 2008 to August 2009, 657 consecutive outpatients with vaginal symptoms in gynecology clinic in the General Hospital of Tianjin Medical University were investigated. Samples were taken for examination of vaginal discharge and fresh wet mount microscopy. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonal vaginitis (TV) were diagnosed according to standardized definitions. Sixty patients with single AV were randomly selected over the same period. Each patient accepted moxifloxacin therapy. Two kinds of treatment course (400 mg qd, 6 days or 400 mg qd, 12 days) were given. Clinical features and laboratory test results in the first visit and follow-ups were recorded and statistically analyzed. RESULT: Among the 657 cases, AV was found in 23.74 % of the cases (156/657). AV mixed infections were diagnosed in 53.85 % (84/156): the mixed infections included VVC (32/84, 38.10 %), BV (31/84, 36.90 %), and TV (21/84, 25.00 %). Common symptoms of AV were a change in the characteristics of the discharge (44/72, 61.11 %) and increased discharge (30/72, 41.67 %). Vaginal pH was usually higher than 4.5 (63/72, 87.50 %). Enterococcus faecalis, Streptococcus viridans, Escherichia coli, and Staphylococcus epidermidis were frequently isolated. There is no statistically significant difference between two moxifloxacin treatment groups (p > 0.05). Cure rate was 89.7 % in 6-day group, and 71.4 % in 12-day group. CONCLUSIONS: AV is a common vaginal infection, and it is often mixed with other infections, especially VVC, BV and TV. The symptoms and signs of AV mixed infections are atypical. If a patient has vaginal complaints, it is necessary to determine whether AV or mixed infections are present. Oral moxifloxacin is effective in treating AV, and an appropriate course should be selected taking the severity of AV into consideration.