RESUMO
This is the first report describing successful visualisation of a tracheo-oesophageal fistula (TEF) based on fluid flow on prenatal foetal ultrasonography. At 36 weeks of gestation, an anechoic tubular structure with a strong blue-coloured stream of fluid flow was observed extending from the trachea towards the gastric bubble on prenatal ultrasonography. TEF can be visualised prenatally under certain conditions.
Assuntos
Atresia Esofágica , Fístula Traqueoesofágica , Gravidez , Feminino , Humanos , Atresia Esofágica/diagnóstico por imagem , Fístula Traqueoesofágica/diagnóstico por imagem , Cuidado Pré-Natal , Feto , Ultrassonografia Pré-NatalAssuntos
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Hérnia Umbilical/diagnóstico , Diagnóstico Pré-Natal/métodos , Síndrome da Trissomia do Cromossomo 13/diagnóstico , Adulto , Amniocentese , Cesárea , Malformação Adenomatoide Cística Congênita do Pulmão/genética , Evolução Fatal , Feminino , Idade Gestacional , Hérnia Umbilical/genética , Humanos , Imageamento por Ressonância Magnética , Gravidez , Ultrassonografia Pré-NatalRESUMO
It is known that hemorrhagic stroke at the perinatal period are caused by specifics conditions like eclampsia as well as by the existing abnormal vessels. We treated a case of HELLP syndrome resulting in eclampsia with non-aneurysmal, convexity subarachnoid hemorrhage. A 34-year-old female, who had been pointed out to have a high level of urinal protein at the 37th week, was seen in the emergency department because of severe headache, vomiting and respiratory discomfort. Her systolic blood pressure was over 190mmHg, and caesarean section was selected. On the way to the operating room, she had a generalized convulsion with loss of consciousness. The delivery was carried out. The CT immediately after the caesarean section revealed faint and localized subarachnoid hemorrhage in the bilateral convexity areas. Additionally, the FLAIR image of MRI demonstrated increased intensity in the bilateral cerebellar hemispheres, basal ganglion and subcortical area, suggesting vasogenic edema. The patient had a good clinical course and the abnormal signal of MRI also recovered by treatment with oral iron and zinc. Here, we report a speculation for the mechanism of this case and precautions against stroke in the perinatal period.
Assuntos
Eclampsia/cirurgia , Síndrome HELLP/cirurgia , Complicações na Gravidez/cirurgia , Hemorragia Subaracnóidea/cirurgia , Adulto , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Eclampsia/etiologia , Feminino , Humanos , Angiografia por Ressonância Magnética/métodos , Gravidez , Hemorragia Subaracnóidea/complicações , Resultado do TratamentoRESUMO
OBJECTIVE: To asses the effectiveness of microwave endometrial ablation (MEA) using a new curved applicator for the emergent control of uterine hemorrhage. STUDY DESIGN: Seven patients received emergency MEA. Three out of seven patients were treated with MEA as their primary procedure, and four out of seven patients were treated for an intraoperative hemorrhage. RESULTS: In all three patients treated preoperatively, MEA was highly effective and successfully controlled acute uterine hemorrhage. Four out of seven patients were treated with MEA for a hemorrhage following resection of a submucosal myoma or polyp. MEA successfully controlled bleeding in all four patients, thereby preventing them from undergoing hysterectomy. CONCLUSION: Our results suggest that emergency MEA is a promising way to control a life-threatening uterine hemorrhage.
Assuntos
Técnicas de Ablação Endometrial , Micro-Ondas/uso terapêutico , Hemorragia Uterina/terapia , Adulto , Serviços Médicos de Emergência , Feminino , Humanos , Menorragia/terapia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Microwave endometrial ablation is a new, minimally invasive treatment option for menorrhagia. Its popularity in many countries is increasing due to its safety and simplicity. CASES: We treated menorrhagia due to submucosal myomas in two patients with a modified microwave endometrial ablation device. Surgery was contraindicated in the first patient secondary to medical co-morbidities and in the second patient because of acute hemorrhagic shock. In both cases, the operation was highly effective and each patient was satisfied with her treatment outcome. CONCLUSION: Given its safety, simplicity, and effectiveness, microwave endometrial ablation may be widely adopted for the emergent control of uterine bleeding in patients with poor surgical candidates.
