RESUMO
INTRODUCTION: Gastro-Intestinal Stromal Tumours (GISTs) are rare with an estimated incidence of only 11-15 per million. In pregnancy, GISTs are an extremely rare occurrence and are thus complex to manage from an ethical, surgical and oncological perspective. PRESENTATION OF CASE: We present the first reported case in the literature of a successful combined lower segment caesarean section (LSCS) and a tumour resection in a 31-year-old pregnant patient presenting with a small bowel GIST. DISCUSSION: We compare and contrast our case with other reported cases of GIST resection in pregnancy and discuss the challenges faced by both patients and clinicians. CONCLUSION: Our case demonstrates that a combined LSCS and GIST resection is feasible. In addition, our case highlights the importance of both the multidisciplinary setting and the consideration of patients' wishes in the successful management of this complex group of patients.
RESUMO
The object of this study was to determine the optimum number of follicular flushing for a maximum number of oocytes to be retrieved. This was a prospective study, based at a private in vitro fertilization centre (Brentwood Fertility Centre, The Essex Nuffield Hospital, Brentwood, Essex UK). Patients attending the IVF centre for assisted reproductive technology were studied. We counted the number of oocytes obtained with each flushing after primary aspiration of the follicle. Some 40% of the oocytes were retrieved with primary aspiration without follicular flushing, while up to 82% of oocytes were retrieved with two flushes and 97% of oocytes were retrieved in up to four flushes. Only 3% of the remaining oocytes were retrieved with 5th and 6th flush. The optimum number of follicular flushing was four times, in order to achieve maximum number of oocytes without compromising the duration of retrieval and number of oocytes retrieved.
