Ovarian pregnancy: a report of twenty cases in one institution

Article Abstract:

In ectopic or extrauterine pregnancies, the fertilized egg implants in tissues other than the uterus. Implantation in the ovary is one of the rarest of ectopic pregnancies and is difficult to diagnose. The symptoms, diagnosis, and treatment of 20 cases of ovarian pregnancy are described in this article. The ovarian pregnancies represented 3.3 percent of all ectopic pregnancies at one institution during a 19-year period, a rate similar to that reported in the literature. However, the prevalence in this group increased during the later years. Eighteen of 20 patients used the intrauterine device (IUD) for contraception. Abdominal pain and menstrual irregularity were the most frequently reported symptoms. Ovarian pregnancy leads to increased growth of blood vessels in the ovary, with associated rupture in many cases. Circulatory collapse due to loss of blood occurred in six patients. Thirteen of the 20 cases were suspected of having ectopic pregnancy before surgery, while other ovarian or abdominal disorders were suspected in the rest. Among eight fertile patients who did not continue contraceptive use and who were available for follow-up study, seven had normal pregnancies and one had an ectopic pregnancy which occurred in the fallopian tubes. Ovarian pregnancies may be associated with IUD use because IUDs (untreated with copper or progesterone) may effectively prevent only uterine and tubal pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Pregnancy, Ectopic, Ectopic pregnancy, Ovaries

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The effect of large uterine fibroids on urinary bladder function and symptoms

Article Abstract:

Women who have large uterine fibroid tumors frequently have symptoms suggesting pressure on the urinary bladder, including increased frequency and urgency, and incontinence. Medical opinion is varied as to whether removal of the tumor relieves the symptoms, whether surgery, which removes the nerve stimulation and regulation of the bladder, exacerbates the problems, or whether urinary symptoms are not related to tumor pressure on the bladder. The relationship between tumor size and urinary symptoms was evaluated in 14 women who were treated with hormonal rather than surgical therapy. Gonadotropin-releasing hormone (GnRH), which decreases estrogen secretion, shrinks fibroid tumors, which are estrogen-dependent. The women were aged 39 to 50 and had given birth to between one and four children. Following two months of treatment with GnRH, tumors shrank in size by more than half. This was associated with significant decreases in nocturnal urination, urgency, and frequency in urination during the day. Decreased uterine size did not alter urge incontinence or stress incontinence. Measurements of bladder function such as capacity and pressure rise on filling did not change in response to treatment. The results support the idea that pressure on the bladder caused by uterine fibroid tumors are responsible for urinary difficulties. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Urinary incontinence, Gonadotropin releasing hormone, Gonadorelin, Uterine fibroids

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Dynamic ultrasonographic imaging of the third stage of labor: new perspectives into third-stage mechanisms

Article Abstract:

Shearing forces during the third stage of labor appear to promote the separation of the placenta from the uterine wall after delivery. These forces are created by contractions of the muscles of the uterus at the site of the placenta. Among 30 women who had continuous dynamic ultrasonographic imaging of the third stage of labor, 25 had a normal delivery and five had prolonged third-stage labor. Normal third-stage labor had four different stages: the latent stage, the contraction stage, the detachment phase and the expulsion stage. The uterine wall is usually thin at the site of the placenta during the latent stage. The contraction phase involves a gradual thickening of the uterine wall at the placental site. After the contraction phase, the placenta detaches from the uterine wall and slides down towards the cervix. The wall of the uterus remained thin at the placental site in one of the women with prolonged third-stage labor. The placenta had to be removed manually from this woman.

Labor (Obstetrics), Placenta

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