Uterine myomas during pregnancy: a longitudinal sonographic study.

OBJECTIVE: To evaluate volumetric changes of uterine myomas (fibroids) during pregnancy. METHODS: This was an observational, longitudinal and prospective study of 38 consecutive Caucasian women with singleton pregnancies and a total of 42 uterine myomas, enrolled from a cohort of 1492 women who took part in our first-trimester Down syndrome screening program. Myoma volume was evaluated by ultrasound at 11-14, 20-22 and 32-34 weeks of gestation. RESULTS: Mean myoma volume increased significantly throughout pregnancy. Taking a volumetric change of > 10% between gestational periods to be an increase in size, 71.4% of uterine myomas increased in size between the first and second gestational periods, while this percentage was slightly lower (66.6%) between the second and third periods. Logistic regression analysis revealed that greater maternal age was correlated with a reduction/no change in overall myoma size and multiparity was correlated with a decrease/no change between the first and second trimesters, while a higher prepregnancy maternal body mass index (BMI) was correlated with a volumetric increase between the first and second trimesters and a decrease/no change between the second and third trimesters. CONCLUSIONS: Fibroids enlarge during pregnancy regardless of their initial size or local factors, and maternal age, prepregnancy BMI and parity are apparently correlated with these changes.

Heterotopic pregnancy: case report.

Heterotopic pregnancy is the simultaneus development of an intrauterine pregnancy and ectopic pregnancy. It is a potentially fatal condition and rarely occurrs in natural conception cycles. A high incidence of heterotopic pregnancy is reported in pregnancies following an assisted reproduction technique (ART) with embryo transfer in utero. We report the case of heterotopic pregnancy via ART in a 42-year-old primigravida. She presented with pelvic pain and intraabdominal fluid collection. She was treated with laparoscopic surgery. At present the intrauterine pregnancy is in normal evolution.

Laparoscopic management of adnexal masses in postmenopause.

The study included 64 postmenopausal women with adnexal masses. The selection criteria included menopausal status, an ultrasound scan indicating a benign mass and serum levels of CA-125 below the cutoff (35 U/ml). The results of the study confirm that the removal of a cystic mass in postmenopausal patients with laparoscopic surgery is a more valid and acceptable alternative to traditional surgery.

Ovarian endometriotic cyst in a patient with Ellis-van Creveld's syndrome: case report.

Ellis-van Creveld (EvC) syndrome, or chondroectodermal dysplasia, is a rare genetic disorder associated with chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital cardiac malformations. The disorder is due to an autosomal-recessive mutation mapped to chromosome 4p16. It may occur with different phenotypes. The case of an ovarian endometriotic cyst in a patient suffering from EvC syndrome is reported.