Submucosal leiomyoma of the uterus incorporated into the fetal membranes and mimicking a placental neoplasm: a case report.

Leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was incidentally discovered on examination of a spontaneously expulsed placenta following Caesarean section. Although it is an uncommon entity, it is known that leiomyomas may arise from the vasculature nourishing the fetal membranes. The baby was male and genetic studies were performed to detect Y chromosome in tumoral tissue. Polymerase chain reaction technique demonstrated Y chromosome in placental tissue but not in tumour tissue. Thus the tumour was finally diagnosed as incorporated benign uterine leiomyoma.

Endoscopy in hyperemesis gravidarum and Helicobacter pylori infection.

OBJECTIVES: To establish a relationship between hyperemesis gravidarum (HG) and Helicobacter pylori (H. Pylori) infection by histologic testing. METHODS: Twenty patients with severe HG (Group I) and 10 volunteer pregnant women without gastric complaints (Group II) were included in the study. Endoscopic evaluations were done in both groups and biopsies were obtained from the antrum and corpus for the histopathologic diagnosis of H. pylori. The groups were compared with the chi(2)-test and Fisher's exact test where appropriate. RESULTS: H. pylori was diagnosed in 19 (95%) of 20 patients in Group I and 5 (50%) of 10 patients in group II. H. pylori densities in the antrum and corpus were higher in Group I and the differences between the two groups were statistically significant. The biopsy specimens revealed significant inflammation and H. pylori activation processes in patients with HG, and in 18 of 19 patients inflammation scores were greater than +2 on the scale. Pangastritis was demonstrated by endoscopic examination in 17 of 20 patients with HG. Enterogastric reflux was also diagnosed in 10 patients. In the control group, three patients had antral gastritis. CONCLUSIONS: We suggest that in patients with intractable nausea and vomiting during pregnancy, pangastritis and enterogastric reflux are the main endoscopic findings and that these findings are closely associated with H. pylori infection, which can be diagnosed histologically. The degree of gastric complaints may be associated with the density of H. pylori infection.

Comparison of the criteria forgestational diabetes mellitus by NDDG and Carpenter and Coustan, and the outcomes of pregnancy.

This is a retrospective study to compare the criteria for diagnosis of gestational diabetes mellitus (GDM) by the National Diabetes Data Group (NDDG), and Carpenter and Coustan criteria, and to study the outcome of GDM when diagnosed by the more sensitive criteria. Six hundred and sixty-two pregnant women were included in this study from the medical records between September 1998 and April 2001. GDM was positive in 6.50% of patients according to Carpenter and Coustan and in 4.08% of patients according to NDDG criteria. Women with GDM were older, had higher fasting and glucose challenge test (GCT) glucose levels, and fetal weight than the normal women. Hypoglycemia was observed only in one infant. Regarding pre-term delivery and pre-eclampsia, there was no significant difference between the groups. Age, delivery week and fetal weight of patients who had caesarian delivery were significantly higher than spontaneous vaginal delivery. Prevalence of macrosomia in GDM group was higher than in the normal group. There was a significant correlation between the macrosomia and number of positive blood glucose values during OGTT. In multivariate analyses, fasting, GCT and second hour OGTT blood glucose levels, mean parity, and delivery week were independent risk factors for fetal weight. Carpenter and Coustan criteria is more sensitive than the NDDG criteria and women with GDM had a higher frequency of macrosomia and the frequency of macrosomia increases by the number of positive blood glucose levels during OGTT. Tight glycemic control might decrease the prevalence of caesarian delivery, pre-eclampsia, pre-term delivery and hypoglycemia of the infant.