Superficial myofibroblastoma (SMF) of the lower female genital tract is a rare, recently recognized benign mesenchymal tumor. We report a very rare case of a superficial myofibroblastoma located in the hymenal ring of a 35 years old Virgin women. On examination, she had a circumscribed nodular mass, located in the posterior portion of the hymen, and exteriorized by the vulvar cleft, measuring approximately 34cm. The surgical treatment was based on local resection, and an hymenoplasty to preserve the virginity of our patient. The histopathological examination revealed a hypocellular tumor, composed of spindle tumor cells with myofibroblastic differentiation, and the presence of nuclear polymorphism, making it difficult to distinguich from a sarcamatous origin. The immunohistochemistry evaluation helped to obtain the diagnosis of SMF, by showing reactivity for estrogen and progesterone receptors, desmin, CD34. The knowledge of the clinicopathological aspect of superficial myofibroblastma is essential to distinguish it from the other mesenchymal lesions of the lower female genital tract. The treatment of this particular localization should consider the preservation of the hymenal ring especially in our cultural context.
ORIGINAL RESEARCH ARTICLE | Feb. 14, 2020
The Effectiveness and Safety of Prostaglandin E2 Pessary versus Intravaginal Gel for Induction of Labor
Salman Al Shahed, Asma Al Shammari, Majd Ghawji, Yasser Habash
Background: The aim of induction of labor is to initiate labor when maternal and fetal conditions necessitate delivery before the onset of spontaneous contractions. The success of this obstetric practice is highly dependent upon the condition of the cervix. Cervical ripening is a complex process that results in physical softening and distensibility of the cervix, ultimately leading to partial cervical effacement and dilatation. Objective: The purpose of the current study was to compare the effectiveness and safety of the pessary to intravaginal dinoprostone gel for induction of labor. Results: A total of 200 women were included in the study, of whom100 received dinoprostone pessary and 100 dinoprostone intravaginal gel. Tachysystole was diagnosed by the research team in 33 women, (4.5%) of those received the pessary and (2.4%) of those received gel (Table 4). In Caesarean section for suspected fetal compromise associated with uterine Tachysystole was performed in seven women in the pessary group and one in the gel group. There was no correlation between the initial Bishop score and the occurrence of uterine Tachysystole. (4.1%) women in the pessary group had a postpartum haemorrhage with estimated volume of ≥ 1000 mL compared to (2.2%) women in the gel group (P = 0.08). Conclusion: In this retrospective study, use of dinoprostone vaginal pessaries for induction of labour resulted in no advantage compared with dinoprostone intravaginal gel and clinically significant tachysystole appeared more common.
CASE REPORT | Feb. 14, 2020
Primary Vaginal Malignant Melanoma: What We Should Do?
Vaginal melanoma is a rare malignant tumor that is aggressive, with a bad prognosis, affecting women in their 6th and 7th decade of life. The factors contributing to its development are not well known. Vaginal melanomas constitute 0.3% of all malignant melanomas and less than 3% of all vaginal carcinomas. To date, there is no clear consensus concerning treatment. A precise and early diagnosis and rapid investigations are essential to arrive to appropriate therapeutic decisions. We described inthis article acase of 31 years old women with primary vaginal melanoma. Our purpose is to focus specealy on management particularitis of this rare gynecological malignant tumor.
Introduction: Sickle cell disease (SCD) results from the substitution of a valine residue for glutamic acid at position 6 in the beta-subunit of hemoglobin. It is characterized by chronic hemolytic anemia, vaso-occlusive process and multiple organ infarction resulting from wide spread vascular occlusion. Sickle cell disease is the most common inherited disorder worldwide. Pregnancy in sickle cell disease is at very high risk. Many reports have documented a considerable maternal risk of morbidity and mortality and high peri-natal adverse outcomes. Case report: 26 year old G3P1D1A1 presented with 39 weeks 4 days gestation with gestational hypertension with mild tricuspid regurgitation with pulmonary hypertension. She was diagnosed with sickle cell disease. Results: Patient is taken for emergency LSCS and transfused with 1 pint packed cells along with Thrombo prophylaxis. Both mother and baby are doing well till date. Conclusion: This case report highlights the fact that anemia in pregnancy should be evaluated systematically and early diagnosis and effective multidisciplinary approach will yield a better maternal and neonatal outcome.
CASE REPORT | Feb. 16, 2020
Pure Mucinous Breast Carcinoma Mimicking a Benign Phyllode Tumor: Case Report and Review of Literature
H Asmouki, J Ouchraa, M Kabine, K Harou, H Rais, A. Soummani
Pure mucinous breast carcinoma is a very rare histopathological type of breast cancer. Despite its invasive nature, mucinous carcinoma is most often described as a benign lump. It can be misdiagnosed as a phyllode tumor, which has certain similarities both clinically and radiologically. Surgery is the cornerstone of therapeutic management: lumpectomy or mastectomy depending on the size of the tumor, associated with axillary lymph node dissection or with sentinel lymph node biopsy procedure for early stage tumors. The treatment is often associated with adjuvant chemotherapy and radiotherapy. We describe an uncommon case of pure mucinous breast carcinoma, which clinical and radiological characteristics, occurred as a benign phyllode tumor presenting a real diagnostic challenge.
ORIGINAL RESEARCH ARTICLE | Feb. 19, 2020
Intrauterine Fetal Demise: A Retrospective Study in Tertiary Care Hospital
Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures. Methods: Retrospective observational study was done from Jan 2019 to Dec 2019 at Government General Hospital, RIMS, Kadap, AP, India. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, mode of delivery, maternal complications Statistical data were analyzed using SPSS version 25. Results: The incidence of IUFD was 29/1000 live births delivered during the reporting period. IUFD incidence was higher in multiparous women compared to primiparous women. The rate of IUFD was almost similar between sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), anhydramnios (6.3%) were some of the other important causes of IUFD. Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.
Uterine sarcomas are rare tumours characterized by clinical and histopathological diversity and poor prognosis.We analyzed diagnostic, prognostic and therapeutic difficulties encountered with these tumors by insisting on the importance of early diagnosis.
CASE REPORT | Feb. 19, 2020
An Uncommon Case of Ectopic Pregnancy: Cornual Pregnancy after Salpingectomy
This is a case report describing an ectopic pregnancy occurring in the remnant stump following salpingectomy. A pregnancy implanted in this location appears very uncommon, thereby rendering the correct diagnosis challenging. This contribution comprises a case description, a presentation of the different diagnostic and therapeutic methods available to date, as well as a succinct literature review. We have also highlighted the requirement of performing salpingectomy by sectioning the isthmus of the uterine tube at the uterine horn, then coagulating the horn's intramural portion. Lastly, we have taken into consideration a series of practical recommendations.
CASE REPORT | Feb. 26, 2020
Retinopathy of Valsalva and Pregnancy
Mohammed Rahmoune, Mounsef Mahaouchi, Omar Laghzaoui, Adil Bouzidi
Valsalva hemorrhagic retinopathy is a rare condition, often responsible for a sharp drop in visual acuity associated with pre-macular retinal hemorrhage. Pregnancy is considered a risk factor. We report a case of Valsalva retinopathy and pregnancy; through a review of the literature we describe the pathophysiological mechanism of this condition as well as the therapeutic management modalities.
ORIGINAL RESEARCH ARTICLE | Feb. 29, 2020
Clinical Study of Prevalence, Risk Factors and Causes of Cerebral Palsy
Cerebral palsy is the commonest physical disability in childhood, occurring in 2.0 to 2.5 per 1000 live births  Cerebral palsy (CP), a neurodevelopment disorders, is usually associated with abnormalities of pregnancy, particularly 'birth asphyxia' and low birth weight . In the present study all cases were males, mothers were more than 35 years, para4, and uncooked, illiterate and low socio economic status. They all had normal deliveries, were anemic, associated with severe pregnancy induced hypertension, preterm and extremely low birth weight and no genetic overlay Present study 5(0.05%) cases occurred out of 8500 deliveries. Cranial ultrasound imaging can describe patterns of neonatal brain damage in the low birth weight infant that are highly predictive of later cerebral palsy [3, 4].
REVIEW ARTICLE | Feb. 29, 2020
Risk Factors of Recurrent Pregnancy Loss in Jalalabad Ragib Rabeya College Hospital, Sylhet
Dr. Shahina Akther, Dr. Dipu Das, Dr. Natia Rahnuma, Dr. Lubna Yeasmin, Dr. Iffana Azam
Subfertility and unconstrained premature birth or unsuccessful labor is two types of conceptive disappointment. Subfertility influences about 10% to 15% of couples. Then again, the danger of fetus removal has been affirmed is about 15% to 20%. The differentiation among essential and auxiliary repetitive pregnancy loss can be made. Essential RPL is depicted as RPL without a past continuous pregnancy past 28 weeks' incubation, while auxiliary RPL is characterized as a scene of RPL after at least one past pregnancies advancing past 28 weeks' development. The main objective of this research is to find out the risk factors of recurrent pregnancy loss. The specific objectives are; to identify the origin of the pregnancy losses, to identify the probable therapeutic targets, and to provide recommendations regarding organization of care for couples faced with RPL. Total 60 samples were selected and the study duration was 3 years. After investigation, it was found that few factors, such as: age, psychological pressure, environmental and occupational exposure, chronic endometritis, smoking, genetic factors, and thrombophilia screening, uterine defects, were some of the risks of RPL. Multiple pregnancy loss can have a noteworthy mental cost for influenced couples, and numerous endeavors are being made to improve medicines and reduction the time expected to accomplish an effective pregnancy.
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