CA 125 and preterm prelabour rupture of the membranes

Article Abstract:

Premature rupture of membranes is the bursting of the membranes that surround the fetus before the onset of labor. This disorder may be complicated by amnionitis, the inflammation of the amniotic membranes surrounding the fetus. Amnionitis was estimated to occur in 60 to 65 percent of cases of premature prelabor rupture of membranes. Unfortunately, signs of amnionitis develop at an advanced stage, and there are few sensitive indicators of this disease. CA 125 is an antigen, or element capable of provoking an immune reaction, that is released by tumors of the ovarian epithelial cells, which make up the outer surface layer of the ovaries. This tumor antigen has been used as a marker of ovarian epithelial carcinoma, a cancer of the ovaries. CA 125 can be detected in the endometrium, the inner lining of the uterus, and the decidua, the lining of the uterus during pregnancy. CA 125 levels are elevated in the decidua, the amniotic fluid, and the blood of the mother during the early part of pregnancy and in patients with pelvic inflammatory disease, an infection of the female reproductive tract. Because elevated levels of CA 125 have been detected in normal pregnancy and in association with inflammation, it was thought that the CA 125 levels may serve as a marker for amnionitis in women with preterm prelabor rupture of membranes. The blood levels of CA 125 and C-reactive protein, which was shown to be elevated in patients with amnionitis, were measured in 17 women after 26 weeks of pregnancy. These women were previously diagnosed with premature rupture of membranes. The results show that CA 125 levels are not correlated with elevated levels of C-reactive protein or incidence of infection. These findings suggest that CA 125 is not a useful marker of amnionitis in patients with premature rupture of membranes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Premature rupture of membranes, Premature rupture of the membrane, Tumor antigens, Chorioamnionitis

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Granulosa cell tumor presenting with haemoperitoneum and splenic rupture: case report

Article Abstract:

Granulosa cell tumor is a fleshy tumor originating in the granulosa cell membrane of the ovary. A 68-year-old woman with no medical history of tumors developed abdominal bloating, difficulty urinating and abdominal pain. A left ovarian tumor was detected and there was fluid in the abdominal space. During abdominal surgery, the ovarian tumor was removed along with a large amount of blood from the cavity. The remaining reproductive organ, which under normal circumstances would also have been removed, was left because of the large amount of bleeding. Evidence of continued abdominal bleeding necessitated a second operation. A large tear was visualized in the spleen, which was then removed. Two more operations were needed to place and remove packing material to control continued abdominal bleeding. The patient received 23 units of blood and required mechanical ventilation. Spontaneous breathing resumed five days later and despite multiple infections and low blood sugar, the patient made continued progress. Four months later she was well enough to return home. The miraculous survival of this woman who experienced many potentially life-threatening events is attributed to her excellent lifelong physical health. Evaluation of the woman's estrogen level, the hormone thought to be involved in causing the tumor, revealed that it was 10 times higher than normal. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hemorrhage, Abdomen, Spleen, Granulosa cell tumor, Hemoperitoneum

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Virilizing ovarian serous cystadenoma: case report

Article Abstract:

An 80-year-old obese woman was seen by a dermatologist for a 17-year history of scalp baldness and excess chest hair. The amount of circulating testosterone, the male hormone, was found to be higher than normal. Ultrasonographic imaging of the ovaries revealed a ovarian cyst (10 centimeters in diameter) with an intact capsule. The entire uterus and both ovaries were removed without complications, and a benign serous cystadenoma was diagnosed. Although the level of testosterone returned to normal, the patient's scalp baldness remained. The cells of the tumor were analyzed, and luteinizing cells, which secrete hormones, were found in the cyst wall. Although ovarian tumors with active cells in the cyst wall generally secrete estrogen, rarely cyst cell walls can secrete virilizing hormones. The mechanisms involved in secreting hormones from the stromal cells of the ovarian cysts are not clearly understood. One theory is that the pressure on adjacent stromal cells caused by the enlarging cyst causes the stromal cells to produce hormones. Although most benign ovarian tumors do not produce virilizing hormones, postmenopausal women experiencing baldness and excess body hair should be evaluated for hormone-producing stromal cells in ovarian cysts. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ovaries, Ovarian cysts, Baldness, Alopecia, Adenolymphoma

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