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Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report
Zidane Farah,
Cherkaoui Malki Nivine,
Sebti Mamoun,
Yousfi Mounia,
Bargach Samir
Issue:
Volume 9, Issue 1, January 2021
Pages:
1-4
Received:
1 October 2020
Accepted:
13 November 2020
Published:
15 January 2021
Abstract: Simultaneous bilateral tubal ectopic pregnancy is a rare entity. The reported incidence ranges between 1 in 725 to 1 in 1580 of all ectopic pregnancies, and it is higher in women undergoing assisted reproductive techniques or ovulation induction. Its spontaneous appearance is almost exceptional. There are no unique features in clinical presentation helping to distinguish it from unilateral ectopic pregnancy. This makes the pre-operative diagnosis difficult, so it’s commonly made during surgery. Whether the ectopic pregnancy is spontaneous or induced, fast management is essential and includes early diagnosis, detailed ultrasound scan, careful contralateral tube control, and also specimen’s histological verification. Thus the treatment will depend on the hemodynamic stability of the patient, the extent of tube damage, as well as the desire for future pregnancies. We report a case of 40 year old patient, gravida 1 without any ectopic pregnancy risk factors, who suffered from abdominal pain and vaginal bleeding at 8 gestation weeks. Endovaginal ultrasound detected adnexal ruptured mass in the right fallopian tube. Urgent laparotomy was performed for suspicious ruptured ectopic pregnancy. A right and left ruptured ectopic pregnancy were found during operation. Bilateral salpingectomy is done and patient is discharged from hospital 3 days later without complications.
Abstract: Simultaneous bilateral tubal ectopic pregnancy is a rare entity. The reported incidence ranges between 1 in 725 to 1 in 1580 of all ectopic pregnancies, and it is higher in women undergoing assisted reproductive techniques or ovulation induction. Its spontaneous appearance is almost exceptional. There are no unique features in clinical presentation...
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Clandestine Abortion Complicated by Intestinal Evisceration by Vaginal Route: About a Case at the University Hospital of Brazzaville
Mokoko Jules Cesar,
Eouani Levy Max Emery,
Buambo Gauthier Regis Jostin,
Potokoue Mpia Sekangue Samantha Nuelly,
Elion Ossibi Pierlesky,
Nguelongo Berthrand Lori,
Itoua Clautaire,
Iloki Leon Herve
Issue:
Volume 9, Issue 1, January 2021
Pages:
5-8
Received:
13 January 2021
Accepted:
27 January 2021
Published:
30 January 2021
Abstract: Introduction. Clandestine abortion, performed under unfavorable conditions, is fraught with complications that can affect both the genitals and extra genitals. Illegal in some developing countries, abortion is responsible for high maternal mortality, of which it is the third cause. Clinical observation. We report the case of a 16-year-old adolescent girl admitted for pelvic pain and genital bleeding with extragenital exteriorization of an intestinal loop following an abortive endo-uterine maneuver, at the end of 16 weeks of amenorrhea depending on the date of the last period. After laparotomy, there was a uterine perforation of the antero-inferior surface with ileo-jejunal evisceration, requiring the performance of an intestinal resection with end-to-end anastomosis and hysterorrhaphy. Conclusion. The complications of clandestine abortions are still relevant in our country, despite the awareness of family planning and contraceptive measures. The lack of a legal framework governing the medical care of abortion leaves free rein to unqualified personnel on the one hand or to artisanal practice on the other, thus exposing them to the risk of high maternal morbidity and mortality.
Abstract: Introduction. Clandestine abortion, performed under unfavorable conditions, is fraught with complications that can affect both the genitals and extra genitals. Illegal in some developing countries, abortion is responsible for high maternal mortality, of which it is the third cause. Clinical observation. We report the case of a 16-year-old adolescen...
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Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases
Yilin Sun,
Ying Cao,
Jiming Chen,
Zhiyong Dong,
Yafeng Zheng,
Yunfen Jiang,
Ruxia Shi
Issue:
Volume 9, Issue 1, January 2021
Pages:
9-13
Received:
18 January 2021
Accepted:
6 February 2021
Published:
27 February 2021
Abstract: Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-mini-incision micro-single-hole laparoscopic surgery was performed in the Department of Obstetrics and Gynecology, the Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University from April 2018 to March 2019. Among them, 8 cases were intrauterine adhesion, 3 cases were uterine submucosal fibroid, 3 cases were uterine septum, 1 case was post-cesarean scar pregnancy, ages from 23 to 45 years old, BMI 17.65-25.48kg/m2. The operation was performed through a 5mm-mini-incision from the midline of the umbilicus. The 40/50 small abdominal retractor was used to expand the incision approach. A 3-mm small lens (A cystoscope or a hysteroscope was used for some patients) was placed into the single-port approach to perform the laparoscopic surgery; hysteroscopic surgery was performed by hysteroscopy through the cervix. Results: All the 15 patients were successfully operated. One patient with severe intrauterine adhesion had uterine perforation during operation. The uterus was repaired and sutured under micro-single-hole laparoscopy perfectly. No other channels were added during operation, and no laparotomy was performed. The operation time was 20-125 min, in which the surgical path establishment time was 5-10 min, the umbilical reconstruction time was 3-5 min; the intraoperative blood loss was 5-10 ml, and the postoperative hospital stay was 3-7 days. The postoperative umbilical incision healed well, and there was no surgical scar in the abdomen after surgery. No postoperative umbilical hernia and other serious complications occurred. Conclusion: Under the premise of mature umbilical single-port laparoscopy, it is safe and effective to use 5mm-mini-incision micro-single-hole laparoscopic surgery as a monitor during hysteroscopy for the diagnosis and treatment of complex uterine cavity diseases. It will achieve a better cosmetic result than traditional laparoscopy.
Abstract: Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-...
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Analysis of Obstetrical Lethality in the Department of Gynecology and Obstetrics of the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO)
Ouattara Adama,
Kiemtoré Sibraogo,
Sawadogo Yobi Alexis,
Ouédraogo Issa,
Barry Fatimata,
Traoré/Millogo Francoise Danielle,
Ouédraogo Charlemagne Marie Rayangwende,
Ouédraogo Ali,
Thieba/Bonané Blandine
Issue:
Volume 9, Issue 1, January 2021
Pages:
14-20
Received:
31 January 2021
Accepted:
8 February 2021
Published:
27 February 2021
Abstract: Objectives: Analyze the determinants of obstetric lethality in the Department of Obstetrical Gynecology at the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO) of Ouagadougou from 2015 to 2018. Methodology: We conducted an analytical, descriptive cross-sectional study on maternal deaths in the UTH-YO. The data were collected retrospectively. All patients meeting the World Health Organization (WHO) definition of maternal death and patients who died as a result of direct obstetric complications in the Department of Gynaecology and Obstetrics at the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO) of Ouagadougou from January 1, 2015 to December 31, 2018 were included. Results: We recorded 484 maternal deaths and 22947 births, for a maternal mortality ratio of 2109 deaths per 100,000 live births (NV). Patients who died as a result of direct obstetric complications accounted for 412 out of 10,564 cases, representing an obstetric lethality rate of 3.9%. These were patients with an average age of 27.6 years, without income generating activities (93.6%), nulliparous and pauciparous patients respectively (26%) and (31%). Most of them came from health facilities in the city of Ouagadougou (50%). The 4 main causes of death were haemorrhages (29.7%), hypertensive disorders (20.8%), abortion complications (16.8%) and infections (14%) respectively. The most lethal causes were thromboembolic pathology (27.27%), infections (13%), abortion complications (7.6%), bleeding (5.4%) and hypertensive disorders (4.2%). The notion of the 3 delays, the insufficient technical platform, the lack of financial resources and the lack of staff qualification were the contributing factors to the causes of death. Conclusion: From our study, it appears, as elsewhere, that most maternal deaths are preventable, hence the need for coordinated action to take effective action against maternal mortality.
Abstract: Objectives: Analyze the determinants of obstetric lethality in the Department of Obstetrical Gynecology at the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO) of Ouagadougou from 2015 to 2018. Methodology: We conducted an analytical, descriptive cross-sectional study on maternal deaths in the UTH-YO. The data were collected retrospectively....
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Clinical Comparison of 5mm Mini-incision Laparoendoscopic Single-Site Hysterectomy and Traditional Laparoendoscopic Single-Site Hysterectomy
Ying Cao,
Yilin Sun,
Jiming Chen,
Zhiyong Dong,
Yafeng Zheng,
Yunfen Jiang,
Ruxia Shi
Issue:
Volume 9, Issue 1, January 2021
Pages:
21-25
Received:
9 February 2021
Accepted:
19 February 2021
Published:
27 February 2021
Abstract: Objective: To investigate the feasibility of 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy and Laparoendoscopic Single-Site hysterectomy in terms of safety, postoperative pain and cosmetic effect. Methods: The medical records of 19 patients who underwent hysterectomy with 5mm mini-•incision Laparoendoscopic Single-Site Surgery (LESS) or traditional Laparoendoscopic Single-Site Sugery in the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University from December 2017 to June 2020 were retrospectively analyzed, including 6 cases in the group of 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy through umbilical ordinary incision (5mm) and 13 cases in the group of traditional Laparoendoscopic Single-Site hysterectomy through umbilical ordinary incision (1.5cm-3cm). Collect and compare the intraoperative blood loss, the operative time, the postoperative hemoglobin descender, the postoperative hospital stays, the probability of postoperative wound infection, the total cost, Visual analogue scale (VAS) of 12 hours after surgery, VAS of 24 hours after surgery and postoperative Body Image Questionnaire (BIQ, including Body Image scale, BIS and Cosmetic Score, CS) in the two groups. Results: There was no intraoperative complication happened, and there was no significant difference between the two groups in the forms of the intraoperative blood loss, operative time, postoperative hospital stays, postoperative hemoglobin descender, the probability of postoperative wound infection, the total cost, VAS of 24 hours after surgery and CS (P > 0.05). But the VAS of 12 hours after surgery of the 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy was lower than traditional Laparoendoscopic Single-Site hysterectomy (1.17±0.14 vs. 2.33±0.19), the BIS of the former was higher than the later (19.83±0.15 vs 19.16±0.28), and importantly the difference was statistically significant (P < 0.05). Conclusion: Laparoendoscopic Single-Site through 5mm mini-incision is safe and feasible. Compared with traditional Laparoendoscopic Single-Site Hysterectomy through ordinary incision, it can not only significantly reduce postoperative pain, but also bring more satisfactory postoperative cosmetic effect.
Abstract: Objective: To investigate the feasibility of 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy and Laparoendoscopic Single-Site hysterectomy in terms of safety, postoperative pain and cosmetic effect. Methods: The medical records of 19 patients who underwent hysterectomy with 5mm mini-•incision Laparoendoscopic Single-Site Surgery (LESS)...
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Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review
Bersaoui Marianne,
Halimeh Rawad,
Msallem Mark,
Chedid Julien,
Feghali Joe
Issue:
Volume 9, Issue 1, January 2021
Pages:
26-30
Received:
10 February 2021
Accepted:
20 February 2021
Published:
27 February 2021
Abstract: Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.
Abstract: Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or prot...
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