Showing 5 results for Uterus
Fatemeh Sarvi , Marzieh Aali ,
Volume 72, Issue 3 (6-2014)
Abstract
Background: Septate uterus is the most common congenital malformation of the uterus in normal population and also patients with recurrent abortions. Pathogenesis of the disease is incompletely elucidated. It is clarified that incomplete absorption of paramesonephric ducts in the first trimester is responsible for septum formation. Hysteroscopy is known as the standard diagnostic and therapeutic procedure for septate uterus. In this study, our aim was to evaluated the effects of hysteroscopic septal resection in improving pregnancy outcomes in patients with unexplained infertility or recurrent abortion.
Methods: Prospective cohort study was conducted in a Tehran University Medical Sci-ences affiliated hospital from April 2012 to May 2013. Eight patients were excluded from the study because of non-reproductive related complains. The other 40 patients went through a prospective cohort study and were treated for septate uterus. All patients had complete history taken and underwent physical examination. Septum size was measured by hysteroscopy. Patients underwent hysteroscopic metroplasty with resectoscope with an equatorial semicircular loop cutting 12 with monopolar energy. Some septum resected by 5 french hysteroscopic scissor. The patients were visited 2 month later for evaluated surgical outcome. This assessment was done by hysterosalpingography (HSG). Patient’s reproductive outcome were followed for 10.33 (SD:±6.43) months.
Results: The mean age in patients was 31.5 (SD±3.02) years. In whole, 48 patients un-derwent hysteroscopic metroplasty. In 52.1% length of septum occupied two third of uterine cavity. Eight patients were excluded from the study because of non-reproductive related complains. There were 29 pregnant patients (72.5%). Fifteen patients became pregnant without intervention (51.7%). 14 patients had pregnancy under ART, while the pregnancy did not occur in 11 patients (27.5%) during this period. Among pregnant population there were 9 miscarriage (31%), 3 preterm (13.3%) and 17 term delivery (50%). Live birth rate in our study was 68.9%. In control hysterosalpingography (HSG), no patients had adhesion or residual ridge.
Conclusion: The findings of this study indicate that hysteroscopic septoplasty is ac-ceptable for improving reproductive outcomes in patients with septate uterus.
Hayedeh Haeri , Fatemeh Movarrei , Ghazaleh Shaker ,
Volume 73, Issue 5 (8-2015)
Abstract
Background: Breast cancer is not only considered as the most common cancer in women but also is known as the second cause of death among them. One of the main causes of death in breast cancer patients is metastasis to different organs such as lymph nodes, bones, lung, liver, brain or other parts of the body. Metastasis to genital organs especially uterus is rare and a few cases are reported.
Case Presentation: In this report we present a case of invasive ductal breast carcinoma metastasizing to a uterine leiomyoma in a 52 year old woman who was admitted to Imam Khomeini Hospital, Tehran, in September 2013, diagnosed and treated by modified radical mastectomy of the right breast six years ago. Currently, she presented with complaint of persistent abnormal uterine bleeding for which hysterectomy was performed. The histopathologic examination of the uterine specimen revealed a focus in the myometrial wall composed of spindle cell proliferation without signs of atypia which was accompanied by epithelial glandular structures with cells containing hypochromatic nuclei embedded in a desmoplastic stroma. Considering the history of invasive ductal breast carcinoma in this patient, the diagnosis of stromal nodule or metastasis from a breast origin was suggested as the main differential diagnosis. The Immunohistochemical study performed with different markers showed positivity for GCDFP15 staining confirming metastasis from the breast carcinoma.
Conclusion: Although metastasis of breast cancer to the genital organs is an uncommon event, breast carcinoma is still considered the second source of extragenital malignant metastasis to the uterus. Overall, the most popular sites for metastasis of breast carcinoma to the female reproductive system include the ovaries and the uterine cervix. The uterine corpus is the least common site involved. In this regard metastasis to a uterine leiomyoma is a rare event.
Samileh Noorbakhsh , Fahimeh Ehsanipour , Niusha Masalegooyan ,
Volume 77, Issue 9 (12-2019)
Abstract
Background: Intrauterine infections (TORCH) lead to the involvement of various organs of the body of the fetus, including the eye. The aim of this study was to determine the frequency and clinical response of eye lesions to specific drugs, in infants with confirmed TORCH induced ocular lesions.
Methods: This historical cohort study from 2011 to 2017, had done in Pediatrics and Ophthalmology Department of Rasoul Akram Hospital, Tehran, Iran. Cases included; 78 infants with confirmed intrauterine infection (TORCH) with ophthalmologic disorders (glaucoma, cataract, and retinitis), 3 cases died (without any treatment). The cases with incomplete diagnosis, no treatment or without follow-up excluded from study. Out of 74 children with confirmed TORCH induced ophthalmologic disorders, finally 37 children (25 cytomegalovirus, 12 toxoplasma) were treated with specific drugs, and clinical response to treatment was followed-up to 1 year by ophthalmologic examination.
Results: From 12 cases with ophthalmologic disorders due to congenital toxoplasmosis, 5 cases had full treatment, 4 cases had complete response. One case had not any improvement. From 25 cases with congenital cytomegalovirus (CMV), 18 patients continued treatment, 9 cases with complete clinical response, 9 cases had not response to antiviral treatment, indeed most non responder cases had central nervous system involvement from birth. The best response observed in CMV infected cases accompanied with sensory hearing loss (without CNS involvement).
Conclusion: Good clinical response of ophthalmic diseases in 80% of congenital toxoplasma; and 50% of congenital cytomegalovirus infected cases. Probably with initial diagnosis and rapid treatment of cases with TORCH induced ophthalmic disorders (especially cases without CNS involvement) it would lead to stopping ocular lesions.
Sara Mirzaeian, Seyedeh Azam Pourhoseini , Mona Jafari,
Volume 78, Issue 7 (10-2020)
Abstract
Background: Approximately 3% to 5% of obstetric patients will experience postpartum hemorrhage (PPH). Even though the most common reason for postpartum hemorrhage, as the main cause of maternal death, is uterine atony; other complications such as laceration, hematoma, inversion, rupture; retained tissue or invasive placenta; and coagulopathy may result in PPH. The main cause of retained placenta can be traced to the history of manual placenta removal, violent and numerous curettages, uterus anatomical abnormalities, placenta accreta or placenta previa, and history of cesarean section. Here, we have presented a case of retained placenta and uterus septum.
Case Presentation: The patient, a 36 years old female, multigravid 11 live 3 ,death 1 and abortion 6, with a history of four normal vaginal deliveries, and history of preterm premature rupture of membrane since the 16th week of pregnancy, was admitted to Imam Reza hospital, Mashhad University of Medical Sciences due to labor pain in 29th week of pregnancy. After a vaginal delivery, she was transferred to the operating room due to a retained placenta. During the initial diagnosis, the patient’s cervix was dilated and manual placental removal was not possible. The ultrasound results showed an 80mm heterogeneous tissue in the fundus, extending to the left cornu. There was no sign of accreta. During hysterotomy, the retained placenta was removed from underneath a thick layer of Uterine Septum, using sponge forceps. Five days later, the patient returned with severe pelvic pain and signs of peritonitis. Laparotomy and hysterectomy were performed on account of uterine incision necrosis.
Conclusion: The most crucial step in the treatment of retained placenta lies in the early detection of its cause. The treatment includes manual or Surgical removed of placenta which can result in bleeding, infection, and a lengthy recovery.
Fatemeh Shakki Katouli , Jayran Zebardast, Zahra Tavoli, Leila Bayani, Fahimeh Zeinalkhani, Reza Mardani , Fahimeh Azizinik,
Volume 82, Issue 4 (7-2024)
Abstract
Background: The prevalence of cesarean section (CS) has recently increased dramatically. Cesarean scar defect (CSD) is one of the most common complications of CS. This study aims to investigate and compare the depth and volume of the CSD in symptomatic patients with and without uterine adenomyosis.
Methods: This retrospective case-control study was done from November 2020 to November 2022 at our referral women's hospital. The patients who underwent sonohysterography with a previous history of one or two CS for at least one year ago and chief complaints of abnormal uterine bleeding were included in our study. The patients with myometrial or endometrial pathology were excluded from the study. The symptomatic patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were obtained from the patient’s documents and archived images. In sonohysterography, CSD features, including the length, depth, width, volume, RMT (Remained Myometrial Thickness), AMT (Adjacent Myometrial Thickness), and RMT/AMT were measured. To analyze the variables, t-tests, and chi-square were used.
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Results: Among 310 symptomatic women with a history of previous cesarean section underwent sonohysterography, 160 patients met the inclusion criteria (case group with adenomyosis: 82 patients and control group without adenomyosis: 78 patients). The chief complaints were post-menstrual bleeding (43.8%), prolonged bleeding (34.3%), and intermenstrual bleeding (21.9%). In the case group, 25.6% had CSD with RMT<2mm, but in the control group (without adenomyosis), only 6.4% had RMT<2mm. CSD depth and volume were significantly larger in patients with underlying adenomyosis (P-value of 0.002 and 0.038, respectively). Also, the mean RMT and RMT/AMT ratio were significantly lower in the case group (P-values of 0.004 and 0.00, respectively).
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Conclusion: Our study demonstrated a strong association between the presence of adenomyosis and larger CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis.
