Relatos de Casos Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):50-52
DOI 10.1590/S0100-72031998000100009
Compound nevus of the uterine cervix is very rare. Benign and malignant melanotic lesions of endo and exocervix have been rarely documented. The present case of compound nevus in the uterine exocervix was found in a 47-year-old woman without gynecologic complaints. Diagnosis was suspected by colposcopic evaluation and confirmed trough histopathological examination. The treatment was concluded with total abdominal hysterectomy based on the possible malignant transformation of these lesions and the difficult patient follow-up.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):50-52
DOI 10.1590/S0100-72031998000100009
Compound nevus of the uterine cervix is very rare. Benign and malignant melanotic lesions of endo and exocervix have been rarely documented. The present case of compound nevus in the uterine exocervix was found in a 47-year-old woman without gynecologic complaints. Diagnosis was suspected by colposcopic evaluation and confirmed trough histopathological examination. The treatment was concluded with total abdominal hysterectomy based on the possible malignant transformation of these lesions and the difficult patient follow-up.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):47-49
DOI 10.1590/S0100-72031998000100008
We report a case in which there was spontaneous regression of hydrops fetalis. Hydrops was probably caused by fetal infection with parvovirus B19. Anemia and hypokinesia of the heart were also observed. Diagnosis was accomplished by the ultrasound, virus detection in maternal serum, complete fetal blood count, and analysis of hepatic enzymes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):47-49
DOI 10.1590/S0100-72031998000100008
We report a case in which there was spontaneous regression of hydrops fetalis. Hydrops was probably caused by fetal infection with parvovirus B19. Anemia and hypokinesia of the heart were also observed. Diagnosis was accomplished by the ultrasound, virus detection in maternal serum, complete fetal blood count, and analysis of hepatic enzymes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):111-113
DOI 10.1590/S0100-72031998000200009
The acardius syndrome is a rare complication of monozygotic twin pregnancies, occurring once in 35.000 births. The outcome is invariably fatal for the acardiac twin and for 50-75% of the normal twins. We report a case of partial (pseudo)acardia in twin pregnancy. The diagnosis was made using ultrasonography, fetal echocardiography and confirmed after delivery.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):111-113
DOI 10.1590/S0100-72031998000200009
The acardius syndrome is a rare complication of monozygotic twin pregnancies, occurring once in 35.000 births. The outcome is invariably fatal for the acardiac twin and for 50-75% of the normal twins. We report a case of partial (pseudo)acardia in twin pregnancy. The diagnosis was made using ultrasonography, fetal echocardiography and confirmed after delivery.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):289-292
DOI 10.1590/S0100-72031998000500009
Pneumoperitoneum, abdominal pain and paralytic ileus in the postoperative period are usually related to perforation of the gastrointestinal tract. The authors present a case of a patient submitted to cesarean section (abruptio placentae) who had a postoperative course of abdominal distention and abdominal pain. Abdominal X-ray showed important dilatation of the colon and small bowel. Pneumoperitoneum was seen on chest X-ray. An exploratory laparotomy was performed because of suspicion of intestinal perforation. The operation showed a marked dilatation of bowel, pneumoperitoneum, and infected hemoperitoneum and subaponeurotic hematoma (Escherichia coli), without any perforation. Postoperative recovery was good and antibiotics were given for 4 days (ceftriaxone + metronidazole). The patient was diseharged from hospital on the 7th day after laparotomy. After review of the literature the authors concluded that this case of pneumoperitoneum was probably related to infection by a gas-producing bacterium in a patient with clinical findings of paralytic ileus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):289-292
DOI 10.1590/S0100-72031998000500009
Pneumoperitoneum, abdominal pain and paralytic ileus in the postoperative period are usually related to perforation of the gastrointestinal tract. The authors present a case of a patient submitted to cesarean section (abruptio placentae) who had a postoperative course of abdominal distention and abdominal pain. Abdominal X-ray showed important dilatation of the colon and small bowel. Pneumoperitoneum was seen on chest X-ray. An exploratory laparotomy was performed because of suspicion of intestinal perforation. The operation showed a marked dilatation of bowel, pneumoperitoneum, and infected hemoperitoneum and subaponeurotic hematoma (Escherichia coli), without any perforation. Postoperative recovery was good and antibiotics were given for 4 days (ceftriaxone + metronidazole). The patient was diseharged from hospital on the 7th day after laparotomy. After review of the literature the authors concluded that this case of pneumoperitoneum was probably related to infection by a gas-producing bacterium in a patient with clinical findings of paralytic ileus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):283-287
DOI 10.1590/S0100-72031998000500008
Turner syndrome and its complications, hydrops and cystic hygroma, can produce alterations in maternal serum biochemical markers used in screening for Down's syndrome and neural tube defects (NTD). The authors report the case of a 37-year-old pregnant woman, screened for Down's syndrome and NTD in the second trimester of pregnancy. The maternal serum alpha-fetoprotein (MSAFP) level was increased and the test was considered screen positive for NTD. A three-dimensional ultrasound investigation was performed, but no fetal or placental anomalies were found, indicating a case of unexplained increased msafp. In the third trimester severe oligohydramnios and disturbances in uteroplacental arterial circulation developed, requiring corticosteroid therapy and premature cesarean section at the 34th week of gestation. The female newborn was transferred to a neonatal ICU and tetralogy of Fallot and Turner syndrome were diagnosed. This case prompted the authors to review the literature on maternal serum biochemical markers in Turner syndrome and congenital heart defects and to propose a protocol for unexplained increased MSAFP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):283-287
DOI 10.1590/S0100-72031998000500008
Turner syndrome and its complications, hydrops and cystic hygroma, can produce alterations in maternal serum biochemical markers used in screening for Down's syndrome and neural tube defects (NTD). The authors report the case of a 37-year-old pregnant woman, screened for Down's syndrome and NTD in the second trimester of pregnancy. The maternal serum alpha-fetoprotein (MSAFP) level was increased and the test was considered screen positive for NTD. A three-dimensional ultrasound investigation was performed, but no fetal or placental anomalies were found, indicating a case of unexplained increased msafp. In the third trimester severe oligohydramnios and disturbances in uteroplacental arterial circulation developed, requiring corticosteroid therapy and premature cesarean section at the 34th week of gestation. The female newborn was transferred to a neonatal ICU and tetralogy of Fallot and Turner syndrome were diagnosed. This case prompted the authors to review the literature on maternal serum biochemical markers in Turner syndrome and congenital heart defects and to propose a protocol for unexplained increased MSAFP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):221-224
DOI 10.1590/S0100-72031998000400008
A case of postsurgical necrotizing fasciitis is presented. A 68-year-old female patient was submitted to a lumpectomy for a big breast lipoma. After surgen there was an aggressive local infection, with extensive necrosis of the breast tissue, including the superficial and deep fasciae and also the skin over the breast. The gravity of the disease and the difficulties in its diagnosis due to the late skin necrosis are emphasized. Under such circunstances an early and aggressive approach is necessary.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):221-224
DOI 10.1590/S0100-72031998000400008
A case of postsurgical necrotizing fasciitis is presented. A 68-year-old female patient was submitted to a lumpectomy for a big breast lipoma. After surgen there was an aggressive local infection, with extensive necrosis of the breast tissue, including the superficial and deep fasciae and also the skin over the breast. The gravity of the disease and the difficulties in its diagnosis due to the late skin necrosis are emphasized. Under such circunstances an early and aggressive approach is necessary.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):217-219
DOI 10.1590/S0100-72031998000400007
A case of urethral leiomyoma - a mass of approximately 5 cm in diameter - located on the anterior wall of the vaginal lower third is reported. The patient was submitted to a surgical tumor excision. Histopathological and immunohistochemical studies indicated leiomyoma, which is always a benign, unusual neoplasm, rarely relapsing after excision. Its pathogenesis and clinical features are also focused on.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):217-219
DOI 10.1590/S0100-72031998000400007
A case of urethral leiomyoma - a mass of approximately 5 cm in diameter - located on the anterior wall of the vaginal lower third is reported. The patient was submitted to a surgical tumor excision. Histopathological and immunohistochemical studies indicated leiomyoma, which is always a benign, unusual neoplasm, rarely relapsing after excision. Its pathogenesis and clinical features are also focused on.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(3):165-167
DOI 10.1590/S0100-72031998000300008
HELLP syndrome is a severe complication of preeclampsia that increases maternal and perinatal morbidity and mortality. Two cases of recurrent HELLP syndrome are described, maternal death occurring in one of the cases. This study is a warning about the increased risk of HELLP syndrome in the next pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(3):165-167
DOI 10.1590/S0100-72031998000300008
HELLP syndrome is a severe complication of preeclampsia that increases maternal and perinatal morbidity and mortality. Two cases of recurrent HELLP syndrome are described, maternal death occurring in one of the cases. This study is a warning about the increased risk of HELLP syndrome in the next pregnancy.