Introduction. Retroperitoneal ectopic pregnancy is extremely rare, but potentially fatal condition due to possible massive hemorrhage, representing a great challenge to clinicians. Case report. We presented early retroperitoneal pregnancy in a patient with previous caesarean section, diagnosed at the sixth gestational week, located in the left broad ligament, primary treated by laparoscopy, which had to be converted to laparotomy due to massive intraoperative bleeding from the implantation site. Conclusion. High index of suspicion, combined with carefully interpreted clinical and ultrasound findings are crucial for the timely diagnosis of retroperitoneal pregnancy, before the occurrence of severe bleeding. The rising, even plateau of serum ?-human chorionic gonadotropin (?-HCG) levels without identification of uterine or ectopic (tubal) pregnancy should cause suspicion on ectopic pregnancy in unusual location.
If there are contrain-ications to menopausal hormone therapy or patients are unwilling to take hormone therapy, alternative treatments, which canlalso solve menopausal symptoms, should be considered.
Introduction: Endometrial carcinoma is diagnosed by histopathological assessment of the sampled endometrium. After establishing the diagnosis the patient needs to be further evaluated in order to establish an optimal treatment. The most important factors that determine the treatment plan include: age, reproduction status, the depth of myometrial invasion, cervical invasion, histopahological type of tumor, histological and nuclear grade. Surgery is the most common treatment. The choice of optimal surgical procedure may include various imaging methods.Aim of the study: Testing the usefulness of applying the ultrasound diagnostics in preoperative evaluation of patients diagnosed with endometrial carcinoma.Method: The prospective study included 61 patients diagnosed with endometrial carcinoma. The ultrasound was used to estimate the presence and depth of invasion of the uterine muscle and cervical inclusion. The obtained parameters were compared to histopathological findings from surgically removed uterus.
Results:The sensitivity of the ultrasound method in the estimation of myometrial invasion in the tested sample was 77.59%, specificity was 100.00%, predictive value of the positive test was 79.03%. The sensitivity of the ultrasound method in the estimation of cervical invasion in the tested sample was only 11.11%, specificity was 90.91%, predictive value of the positive test was 33.33%, predictive value of the negative test was 71.43%, whereas total accuracy of the method was 67.74%.Conclusion: Ultrasound diagnostics can be used in the assessment of the depth myometrial invasion but not in the assessment of cervical inclusion.
Colposcopy was exhibited somewhat higher sensitivity compared to HPV typization (94.7 : 90), but lower sensitivity (79.27 : 86.6). The usage of HPV typization in the triage of patients with ASC cytologic smear induces statistically significant reduction of unnecessary percentage of cervical biopsies.
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