Spontaneous bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. Bilateral tubal pregnancies in the absence of preceding induction of ovulation are a rare occurrence, with an estimated incidence of 1 in 725 to 1 in 1580 ectopicpregnancies. They are usually diagnosed at the time of surgery. We report a case of spontaneous bilateral tubal pregnancies diagnosed intraoperatively. A 33-year-old patient was admitted after light vaginal bleeding, 35 days after her last menstruation. A bilateral salpingectomy was performed without complication and the pathology report confirmed the diagnosis. This is an unusual case of early diagnosis. The diagnosis of bilateral tubal pregnancy is usually madeintraoperatively. This underscores the importance ofidentifying and closely examining both tubes at the time ofsurgery, even in the presence of significant adhesive disease.
Steroid cell tumors account for less than 0.1% of all ovarian tumors. There are three steroid cell tumor subtypes: steroid cell tumor not otherwise specified (NOS), stromal luteoma and Leydig cell tumor. Steroid cell tumor, NOS, is the most common type and has malignant potential. We report the case of 39-year-old woman complaining of pelvic pain and amenorrhea. Physical examination revealed hirsutism. Transvaginal ultrasound showed an hyperechogenic homogenous cyst of 4 centimeters of the left ovary without signs of malignancy. The right adnexa was normal. MRI imaging showed a left ovarian mass of 34 mm × 30 mm with enhancement after intravenous gadolinium. A left salpingo-oophorectomy was carried out with peritoneal cytology by laparoscopy. Histology concluded to a steroid cell tumor not otherwise specified, which had a low malignant potential. After 2 months, we noticed the regression of hirsutism and the patient had normal menses. She's currently pregnant at 6 months of gestation. A complete surgical staging will be achieved after childbearing.
Key Clinical MessagePerineal myomas in female are exceptional. We report the second case in literature of perineal myomas. It is a case of bilateral perineal myomas lifting the skin occurring in a female patient of 49 years old. She was operated by perineal incisions. Histopathology confirmed the fibromatous nature without signs of malignancy.
IntroductionOur study objective was to analyze the optimum conditions for pregnancy in kidney transplanted women. For that, we conducted a retrospective study was from 1992 to April 2011 about 17 pregnancies in 12 kidney transplanted patients followed in the Department of Obstetrics and Gynecology and Organ Transplant Unit of the Military Hospital of Tunis.MethodsWe studied nephrological parameters and obstetric pathologies encountered during pregnancy and the potential impact of pregnancy on graft. Our main outcome measures were: time between renal transplantation and conception, birth of a living child, renal graft defect.ResultsThe mean age at the time of renal transplantation was 30.11 years. The average age at the time of conception is 34.23 years. The average time between renal transplantation and the occurrence of pregnancy was 46.94 months. More than 40% of pregnancies were not planned. Of the 17 pregnancies, 12 have advanced beyond the first trimester with 91.6% resulting in the birth of a living child. Toxemia was found in 60% of cases, low birth weight in 50%, preterm in 30% and intrauterine growth retardation in 20% of cases. Cesarean section was indicated in all cases. Graft survival was 90% with a mean of 6 years after delivery.ConclusionPregnancy in kidney transplanted patients is a high-risk pregnancy, but pregnancy does not appear to affect graft function through certain conditions.
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