Mainly atypical VD in the first stage was a characteristic FHR pattern for VCI and HCC, and the appearance of such a pattern in cases with antepartum information on these abnormalities could suggest unfavorable fetal status.
Objectives: To investigate the association between the amount of Wharton’s jelly (WJ) and the umbilical coiling index (UCI). Methods: The subjects included 140 pregnant women in the 2nd or 3rd trimester. The antenatal UCI was calculated as the reciprocal of the distance between a pair of coils. The sonographic cross-sectional areas of the cord, arteries and vein were measured. The WJ area was calculated by subtracting areas of the total vessels from the cord. Results: UCIs were significantly smaller and WJ areas were significantly greater in the 3rd trimester than in the 2nd trimester. No correlations were observed between the UCI and WJ area in both trimesters. Conclusion: There is a reduction of the UCI during pregnancy. No direct correlations were found between the amount of WJ and UCI.
A 23-year-old woman, gravida 1, para 1, was transferred to our hospital with acute lower abdominal pain and vital signs consistent with shock. Her urine concentration of human chorionic gonadotrophin was 8000 mIU/mL. Transvaginal ultrasound revealed an echo-free space with mosaic echo pattern in the right adnexal area and no gestational sac in the uterus. With a preoperative diagnosis of ruptured ectopic pregnancy, emergency laparotomy was performed. The rectouterine pouch was filled with many clots containing small amounts of villous tissue. After removal of the conceptus, which was infiltrating into the peritoneum of the Pouch of Douglas, bleeding was controlled by Argon laser. Histological examination of the conceptus by immunohistochemical staining with p57(kip2) showed features of complete hydatidiform mole. This case demonstrates that the peritoneum in the Pouch of Douglas is a possible site of ectopic complete hydatidiform mole occurrence and that immunohistochemical stain is useful to confirm the diagnosis of ectopic complete hydatidiform mole.
We report a rare case of cervical cystic adenomyoma. It is an extremely rare disesase. A 33-year-old female (gravia 0, para 0) presented with progressive dysmenorrhea. She underwent ovarian cystectomy twice for endmetriosis before. Dysmenorrhea was so severe that medical therapy is only marginally effective. Transvaginal ultrasonography and MRI showed a 2 cm cervical cyst that is located within the uterine muscular. It contained blood within the cystic leigion. Under a diagnosis of cervical cystic adenomyoma, laparoscopic excicion was performed. Pathological findings showed the endometrial glands and stroma within myometrial nodule. Symptom improved dramatically after laparoscopic surgery. Cervical cystic adenomyoma is so rare that we did not think that it was cystic adenomyoma initially. We thought history of surgery is involved in cyst formation. Strong clinical symptom appear in cervical cystic adenomyoma as same as that in uterine corpus.
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