Introduction: Paediatric & Adolescent Gynaecology is a special field and also part of the everyday practice. This paper studies the problems adolescent females present with at the Obstetrics & Gynaecology (O&G) Emergency Department (ED). Material and Methods: Data regarding adolescent females that were examined at the O&G ED over one year (2018) were extracted from the records of Konstantiopouleio General Hospital, Athens, Greece. Results: Of the 1534 women that attended O&G ED over one year, 111 were under 19 years old (7%). Of the 83 gynaecological cases, the presenting symptom was pelvic pain in 54 (65%), irregular vaginal bleeding in 11(13%), urinary tract symptoms in 11(13%), vaginal discomfort in 3 (4%) and others in 4 (5%). In 39 (47%) no urgent gynaecological pathology was detected. There were 11 cases (13%) of ovarian cysts, 10 of urinary tract infection (12%), 7 (8%) of other surgical pathology, 6 (8%) of first trimester pregnancy complications and 10 others. Of the 28 pregnant adolescents, 10 complained of abdominal pain (36%), 6 of hyperemesis (21%), 5 of myometrial activity (18%), 4 of vaginal bleeding (14%). In 18 cases (64%) no acute medical condition was diagnosed, 4 were admitted in active labour (14%) and one with threatened delivery, two were referred to other specialties and three refused the examination. Conclusion: O&G emergency conditions in adolescent females are common and potentially serious. Healthcare professionals need to be aware and alert to the special needs of this significant and sensitive population group.
Borderline ovarian tumors, or tumors of low malignant potential, are neoplasms of good prognosis that affect mostly patients of reproductive age. They account for 15% of all epithelial ovarian neoplasms and they are managed with surgical cytoreduction. Conservative surgery may be considered in patients who desire fertility preservation. Here we report on a patient who presented with vague abdominal symptoms and was diagnosed with large bilateral borderline tumors, of 18 and 15 cm in size. She underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and epiplectomy and received adjuvant chemotherapy. Borderline ovarian tumors are a pathologic entity the gynaecologist should be well acquainted with.
Ruptured ectopic pregnancy represents an emergency gynecological procedure. Performing the major cause of maternal death among first trimester pregnancies. Although the mortality incidence decreases, the incidence of ectopic pregnancy is constantly increasing. The simultaneously existence of endometrial and ectopic pregnancy represent a rare condition requiring specific treatment. In cases with severe anemia an urgent management is mandatory. We present a case of heterotopic pregnancy with tubal rupture accompanied with severe anemia successfully surgically treated.
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