RESUMEN
OBJECTIVE: Venous malformations of the uterine cervix are extremely rare. Most lesions are asymptomatic and incidental, but sometimes, they may present with abnormal and/or intractable vaginal bleeding. The study aimed to describe a case of venous malformation of the uterine cervix and discuss the clinical and histopathologic differential diagnosis of this entity. CASE: A 50-year-old woman attended to the gynecology clinic for postcoital spotting and postmenopausal bleeding. Gynecologic examination revealed polypoid, lobulated, bluish, vascular nodular lesions 4 to 1 cm in size surrounding the cervical introitus. The lesions were completely excised via loop electrosurgical excision procedure method. Pathologic diagnosis revealed venous malformations of the uterine cervix. CONCLUSIONS: Venous malformations of the uterine cervix should be considered in the differential diagnosis of patients with cervical mass and vaginal bleeding. Pathologic examination is necessary in such a case to exclude the possibility of malignant vascular tumor or cervical neoplasm.
Asunto(s)
Malformaciones Arteriovenosas/diagnóstico , Malformaciones Arteriovenosas/patología , Cuello del Útero/patología , Malformaciones Arteriovenosas/cirugía , Cuello del Útero/cirugía , Diagnóstico Diferencial , Femenino , Histocitoquímica , Humanos , Persona de Mediana Edad , Neoplasias del Cuello Uterino/diagnóstico , Hemorragia Uterina/etiologíaRESUMEN
PURPOSE: To study the effect of maternal lipid profile changes in pregnancy in relation to fetal growth and development, prognosis, and complications of pregnancy. METHODS: One thousand pregnant women between 17 and 48 years of age were included in this prospective longitudinal and uni-center study. Lipid profile tests [triglyceride (TG), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL)] were first requested as part of the routine pregnancy follow-up in first antenatal visit (<14 weeks) then repeated in the last trimester (>28 weeks). The analysis included the medical, social-demographic, and nutritional status of the women as well. Primer outcome measures were defined as the association of the pregnancy-related lipid profile change to neonatal weight, the weight of the infant in third month and pregnancy complications (preeclampsia, gestational diabetes mellitus, IUGR, and preterm birth). RESULTS: The levels of TG, total cholesterol, HDL, LDL increased significantly as pregnancy progressed. The percentage of the change in the TG levels were higher in patients with well nutritional parameters (p = 0.033). As the percentage of change in the TG levels increased, the neonatal weight increased (p = 0.033) but no effect on the placental weight and the third month weight of the infant was seen. As the percent change in TG levels decreased, the risk of the preterm birth significantly increased. In women who were positive in 50 g screening test, but were uncomplicated with gestational diabetes mellitus, the percent change in cholesterol was lower (p = 0.010), the percent change in LDL was lower (p = 0.015), and the percent change in TG was higher (p = 0.032). CONCLUSION: In pregnancy, complex alterations occur in lipid metabolism. Percent change in TG is affected positively by the nutrition level. The neonatal weight also increases as well but postnatal weight is unaffected. Conversely TG levels significantly decrease in preterm birth. No association between preeclampsia and gestational diabetes mellitus with lipid profile changes were noted except in patients with glucose intolerance (>140 mg/dl in 50 g screening test) in which change in cholesterol, LDL was low and TG was high.