RESUMO
The endometriosis has been observed in 10% of the women in reproductive age and it is found in pelvis in most of the cases. However, occasionally it is located on nonpelvic organs and infrequently in diaphragmatic location. Two cases of diaphragmatic endometriosis with symptoms are presented and treated with CO2 laser successful. There are a few reports of laparoscopic treatment of diaphragmatic endometriosis. The patients with clinical diagnosis of endometriosis and nonpelvic symptoms have the possibility of the disease in nonpelvic organs. The adequate treatment will be in benefit of the patient.
Assuntos
Dióxido de Carbono/uso terapêutico , Endometriose/cirurgia , Terapia a Laser/métodos , Adulto , Diafragma/patologia , Diafragma/cirurgia , Feminino , Humanos , Laparoscopia , Pelve/cirurgiaRESUMO
In obstetrics, the uterine tamponade has been used for the control of acute uterine bleeding. However, the control of the acute hemorrhage from the nonpuerperal uterus is more difficult. Four cases are presented with uterine bleeding during dilation and evacuation without response to medical treatment. They were treated with the use of the Foley catheter for 12 to 24 hrs. There were not complications. The uterine tamponade with Foley catheter is a therapeutic option before the radical surgical treatment.
Assuntos
Oclusão com Balão , Cateterismo , Metrorragia/etiologia , Aborto Espontâneo/complicações , Doença Aguda , Adulto , Cesárea/efeitos adversos , Dilatação e Curetagem/efeitos adversos , Feminino , Humanos , Metrorragia/terapia , Gravidez , Resultado do TratamentoRESUMO
The objective was to evaluate the utility of the ovarian hyperstimulation with menotropins as treatment of unexplained infertility. One hundred couples with unexplained infertility were treated. Ovarian stimulation was started with 150 IU of menotropins on day 3 of the menstrual cycle, monitoring the follicular growth with transvaginal ultrasonography, additional doses of menotropins were administered accordingly. Human chorionic gonadotropin (10000 IU) was administered when the dominant follicle reached a diameter > or = 16 mm. The pregnancy rate per cycle was 12.0%, on the other hand the cumulate rate of pregnancy was 48.0%. The age under 30 years and the antecedent of previous pregnancies were correlated with the likelihood of conception. The spontaneous abortion rate was 35.4%. As conclusion, it therefore appears appropriate, to offer a treatment with menotropins to that specific group of couples with unexplained infertility with good prognostic factor as age < 30 years and infertility duration < 5 years. The increase on the spontaneous abortion rate was probably induced for the luteal insufficiency produced by the ovarian hyperstimulation with menotropins.
Assuntos
Fármacos para a Fertilidade Feminina/uso terapêutico , Infertilidade Feminina/tratamento farmacológico , Menotropinas/uso terapêutico , Indução da Ovulação/métodos , Aborto Espontâneo/prevenção & controle , Adulto , Feminino , Humanos , Ovário/efeitos dos fármacos , Gravidez , PrognósticoRESUMO
The objective was to evaluate the utility of the pure FSH as treatment of women clomiphene-resistant. Seventy two patients clomiphene-resistant were treated with pure FSH. Ovulation induction was started with 75 IU of pure FSH on day 3 of the menstrual cycle, monitoring the follicular growth with transvaginal ultrasonography, additional doses of pure FSH were administered accordingly. Human chorionic gonadotropin (10,000 IU) was administered when the dominant follicle reached a diameter > or = 16 mm. The pregnancy rate per cycle was 18.0%, on the other hand, the cumulate rate of pregnancy was 72.2%. There was not significant difference in the pregnancy rate between patients with primary or secondary infertility. The rate of spontaneous abortions was similar to the general population. As conclusion, it therefore appropriate to offer the treatment with pure FSH to patients clomiphene-resistance. The cases with gonadotropin-resistance, will be candidates to surgical procedures.
Assuntos
Anovulação/tratamento farmacológico , Clomifeno/uso terapêutico , Fármacos para a Fertilidade Feminina/uso terapêutico , Hormônio Foliculoestimulante/uso terapêutico , Indução da Ovulação/métodos , Adolescente , Adulto , Doença Crônica , Resistência a Medicamentos , Feminino , Humanos , Gravidez/estatística & dados numéricosRESUMO
Two extreme cases of pregnancy-induced hypertension with puerperal HELLP syndrome are presented and the literature is review. HELLP is an English acronym, for describing the preeclamptic or eclamptic patient, who also has hemolysis, elevated hepatic enzymes and low platelets. Its etiology has not been elucidated, but it has been accepted the theory of dysequilibrium in prostanoid metabolism. It has an incidence of 5 to 15% among patients with pregnancy-induced hypertension. Maternal mortality is about 10 to 28% and neonatal of 40%. Owing to fatal complications, treatment consist of interrupting pregnancy. Point out the importance of early detection of this clinic entity, which improves maternal-fetal prognosis.
Assuntos
Síndrome HELLP , Transtornos Puerperais , Adulto , Cesárea , Feminino , Morte Fetal/etiologia , Síndrome HELLP/diagnóstico , Humanos , Recém-Nascido , Gravidez , PrognósticoRESUMO
Heterotopic pregnancy, or coexistence of intrauterine and extrauterine pregnancy, is a rare entity, with a difficult pre-operative diagnosis, and potentially dangerous for the mother and for the intrauterine pregnancy. There are risk factors that are increased by this entity, so it should be taken into consideration if assisted reproduction techniques are used. The use of ultrasonography and laparoscopy is fundamental for detection, in order to implant an opportune treatment. Two cases of heterotopic pregnancy with viability of intrauterine gestation, are presented.
Assuntos
Infertilidade Feminina , Inseminação Artificial Homóloga , Gravidez Múltipla , Gravidez Tubária/diagnóstico por imagem , Adulto , Gonadotropina Coriônica/administração & dosagem , Clomifeno/administração & dosagem , Transferência Embrionária , Testes de Obstrução das Tubas Uterinas , Feminino , Fármacos para a Fertilidade Feminina/administração & dosagem , Fertilização in vitro , Humanos , Infertilidade Feminina/terapia , Indução da Ovulação/métodos , Gravidez , Resultado da Gravidez , Gravidez Tubária/cirurgia , Salpingostomia , Ultrassonografia Pré-NatalRESUMO
The Ehlers Danlos Syndrome is a hereditary alteration of connective tissue, characterized by hyperelastic joints, tissues, and skin. The papers about the obstetric and gynecological aspects of Ehlers Danlos syndrome is mostly anecdotical and much has not originated from obstetricians and gynecologists. The complications are important for the feto-material binomial. The case presented here is related with a 39.1 of gestation associated with Ehlers Danlos syndrome, and a description of antenatal period, labor and delivery is done. Literature revision and possible relation with obstetrical care and pregnancy resolution in commented.
Assuntos
Síndrome de Ehlers-Danlos , Complicações na Gravidez , Adulto , Índice de Apgar , Cesárea , Síndrome de Ehlers-Danlos/diagnóstico , Síndrome de Ehlers-Danlos/genética , Feminino , Humanos , Recém-Nascido , Paridade , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-NatalRESUMO
The present review has the objective to describe the chemical and pharmacological characteristics of GnRH analogs and the present time indications of it's use in gynecology. It is a critical review about use of GnRH analogs in: Anticonception, Assisted reproduction, Uterine leiomyomas, Endometriosis, Polycystic ovarian syndrome, Precocious puberty, Premenstrual tension syndrome and breast cancer.
Assuntos
Hormônio Liberador de Gonadotropina/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Anticoncepcionais Orais Hormonais/administração & dosagem , Endometriose/tratamento farmacológico , Feminino , Neoplasias dos Genitais Femininos/tratamento farmacológico , Hormônio Liberador de Gonadotropina/análogos & derivados , Humanos , Indução da Ovulação , Síndrome do Ovário Policístico/tratamento farmacológico , Puberdade Precoce/tratamento farmacológicoRESUMO
The present review has the objective to describe the chemical and pharmacological characteristics of GnRH analogs and the present time indications of it's use in gynecology. It is a critical review about use of GnRH analogs in: Anticonception, Assisted Reproduction, Uterine leiomyomas, Endometriosis, Polycystic Ovarian Syndrome, Precosious Puberty, Premenstrual Tension Syndrome and Breast Cancer.
Assuntos
Hormônio Liberador de Gonadotropina/análogos & derivados , Neoplasias da Mama/tratamento farmacológico , Anticoncepcionais Orais Hormonais/administração & dosagem , Endometriose/tratamento farmacológico , Feminino , Neoplasias dos Genitais Femininos/tratamento farmacológico , Hormônio Liberador de Gonadotropina/administração & dosagem , Humanos , Indução da Ovulação , Síndrome do Ovário Policístico/tratamento farmacológico , Gravidez , Puberdade Precoce/tratamento farmacológicoRESUMO
Seventy five patients were studied. They underwent diagnostic laparoscopy-hysteroscopy. All of them had hysterography. This study was conducted at Biology of Reproduction Department of Instituto Nacional de Perinatología. Laparoscopy-hysteroscopy showed better results to obtain diagnostic and therapeutic information, than the other methods separately without significately increase in surgery time and without complications.