Uterine prolapse during pregnancy is an uncommon condition. It can cause preterm labor, spontaneous abortion, fetal demise, maternal urinary complication, maternal sepsis and death. We report the case of uterine prolapse in a 32-year-old healthy primigravid woman. She had no risk factors associated with uterine prolapse. She was conservatively treated, resulting in a successful vaginal delivery. This report is a very rare case of uterine prolapse in a young healthy primigravid woman, resulting in a successful vaginal delivery.
Spontaneous complete chorioamniotic membrane separation (CMS) without invasive fetal procedure is extremely rare and associated with adverse perinatal outcomes. A woman with complete CMS which was detected at the 21 weeks' gestation. She did not take any fetal invasive procedures before the diagnosis. At 27 weeks' gestation, an emergency Caesarean section was performed because of fetal distress. The defect of the uterine muscle was detected on the fundus. The baby has grown well without any morbidity. This is the first reported case of complete CMS relative to uterine scar. And we suggest that the pregnancy can be maintained successfully if there is no fetal abnormality when complete CMS is detected on ultrasound.
Objectives: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. Methods: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. Results: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cutoff of 150-with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4%-showed the highest performance in determining the malignant tendency of pelvic masses. Conclusion: Accepting a RMI 1 cutoff value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.
After the discovery of melanocytes in the cervix in 1959, it was recognized that primary malignant melanoma of the cervix exists as a separate entity. A 74-year-old woman visited hospital for vaginal bleeding from a black colored cervical mass. The pathology of cervical punch biopsy showed a malignant melanoma with positive immnunohistochemical stainings for S100 protein and HMB-45 antibody. Abdominal radical hysterectomy with pelvic and paraaortic lymphadenectomy was performed. The fi nal pathology was a malignant melanoma of the cervix with metastases for both external iliac lymph nodes and tumor involvement in the margin of vaginal resection. She received cisplatin based concurrent chemoradiotherapy postoperatively. But 6 months later, she received another chemotherapy with dacarbazine and cisplatin for recurrence. We report a case of a 74-year-old patient with a malignant melanoma of the uterine cervix with a brief review.
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